Electronic Annual Report Request Form
 

 
Utility Information
Fields denoted by the * are required.		    
Utility Name *    
Utility Type
Select
W for Water or S for Sewer		 *    
Utility Class
Select A, B, C or D 		*    
Contact Person
Name of Person
Responsible
for
Books & Records 		*     
Phone #
Example: xxx-xxx-xxxx		 *    
Email Address
Where template should
be sent 		*    
 


     

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