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2. Transfer a Service

   To transfer your current Northlake water service to another Northlake address, please complete this form.

   Please contact Utility Billing at utilitybilling@town.northlake.tx.us or 940-648-3290 with any questions. 

6. Service Type*

   Is this a residential or commercial property?

   1. Residential

   1. Commercial
8. What type of property is this?*

   1. Owner Occupant

   1. Landlord/Property Manager

   1. Renter/Tenant
10. Disconnect Service
12. Requested Service End Date*
    Requested Service End Date
14. Service Address to be Disconnected*
16. New Service
18. Requested Start Date for New Service*
    Requested Start Date for New Service
20. Customer Name*
22. Contact (if billed to company or an organization)
24. Address*
26. City*
27. State*
28. Zip Code*
30. Contact Phone Number*
31. Contact Email*
33. Driver's License Number or Tax Identification Number (TIN)*
34. State Issued*
36. Account Privacy*

    With your authorization, the Town of Northlake can withhold the release of your personal information (i.e. phone number, social security number, address) pursuant to Section 182.052 of the Texas Utilities Code. Would you like the Town of Northlake to keep your information confidential?

    1. Yes, keep my personal information confidential
    2. No
38. Billing Options*

    Your utility bill can be sent via e-mail or postal service. Please choose how you would like to receive your bill. Select all that apply. 

    1. Send my bill via e-mail
    2. Send my bill via the postal service
40. Required Documents for Viewing
    Public Notice Requirement for Notification Upon Usage of Chloramines

    Please download and view the attached document at the link above. Once you have viewed the document, please check the box stating that you have read the provided document. 

42. Have you downloaded and read the required documents in this section?*

    1. Yes, I have downloaded and read the required documents in this section
44. Authorization for Transfer of Account Services*

    I agree and understand that I responsible for this account and that all bills must be paid on or before the due date or be subject to late charges and/or possible termination of service.

    1. Yes, I agree to the above statement
    2. No, I do not agree to the above statement
46. Name of Individual Authorizing Transfer of Services*
47. Date*
    Date
49. Enter the account number from your last bill for the account you wish to transfer:
51. Route Number*
52. Service Address ID*
53. Resident Number*
55. 
59. Upon completion and submittal of you application for a disconnection of services, you will be returned to the Utility Billing page for the Town of Northlake's website. Please contact Utility Billing with any questions or concerns.
Leave This Blank:


61. 1. Receive an email copy of this form.
62. Email address

    This field is not part of the form submission.

63. Submit Submit and Print

* indicates a required field