2. Request Type*

   1. Start New Service & Open Account
   2. Stop Service & Close Account
3. Date to Start Service*
   Date to Start Service
4. Date to Stop Service*
   Date to Stop Service
   Date cannot be prior to today's date.
5. Customer Type*

   1. Owner
   2. Renter
   3. Property Manager/Realtor
7. First Name*
8. Last Name*
10. Service Address*
11. Is Mailing Address Same as Service Address?*

    1. Yes
    2. No
13. Forwarding Address*
15. City*
16. State*
17. Zip*
19. Mailing Address*
21. City *
22. State*
23. Zip*
25. Contact Phone*
26. Email Address*
28. Last 4-digits of your SSN#*
29. Drivers License #*
30. State of Issuance*

    1. WA
    2. Other
32. Additional Responsible Party*

    Do you want to add an additional person to the utility account?

    1. Yes
    2. No
34. First Name
    We may need to abbreviate the name provided in order to fit within our utility billing fields.
35. Last Name
37. Comments
    Please provide any additional information
Leave This Blank:


39. Submit

* indicates a required field