Bring this completed form to City Hall If you have any questions, please contact us

located at 201 East Parsons Street in at (512) 272-5555 or e-mail us at

Manor, Texas. questions@cityofmanor.org
CITY OF MANOR
UTILITY SERVICE APPLICATION
Primary Name On Account

FIRST MI LAST

DOB(MMDDYYYY) SS#

DL# STATE
Secondary Name On Account (OPTIONAL)

FIRST MI LAST

DOB(MMDDYYYY) SS#

DL# STATE
Home Information

YEAR HOME BUILT BUYING/RENTING SERVICE START DATE

PHYSICAL ADDRESS

MAILING ADDRESS

HOME PHONE WORK PHONE CELL PHONE

E-MAIL ADDRESS
If Renting Or Leasing

PROPERTY MANAGER/ OWNER NAME

ADDRESS PHONE
Subdivision Information
SELECT YOUR SUBDIVISION OTHER
Subdivisions NOT serviced by the City of Manor include: ShadowGlen, Briar Creek, & Presidential Meadows.

The City of Manor requires one of the following forms of identification to establish service: a valid driver's license, state identification, U.S. identification, visa,
worker's card or passport. A $150.00 deposit and a #35 connection fee must be paid at the time service is requested.
Failure to pay your bills by the due date will result in a late penalty. Payment extensions may not exceed 10 days and must be made in advance of the
due date. No more than two extensions are permitted per year. Payments not received by 5:00 p.m. on the service disconnect date will result in a disconnect fee
of $50 for the first incident and $100 thereafter, regardless of whether the service has actually been disconnected. Fees can not be waived. A $35 fee will be
charged for each returned check. A returned check will count as one extension. Only cash or money orders will be accepted after the second returned check. A
$150 administrative fee will be assessed if an account is past due 3 times in one calendar year.
Upon final termination of services and payment in full of your bill, any remaining deposit will be refunded within thirty days. No interest is paid on
deposits. Accounts which abandoned or terminated service without contacting the city will be assessed a $25 fee annually against the remaining deposit.
Please assure that all interior and exterior faucets are turned off prior to requesting water service. City crews will turn off the customer water valve if
the meter indicates water running in the premise with no one home. The city is not responsible for resulting flooding.
Interconnections with other water systems, including a well on premise, are prohibited. The terms and conditions of service are established by City of Manor
Ordinance 315. If you agree to these terms and conditions, please sign and date below.
CHECK FOR CONFIDENTIALITY OF YOUR RECORDS

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