Required fields are marked with asterisks (*)

Welcome

Please complete the form to setup your new water account.

Please indicate if you are an Owner or Tenant.

Owner

Tenant

New Occupant Name

New Service Address

Mailing Address if different from above

Date of Occupancy

Are you moving from an existing residence in Woolwich Township?

Yes

Please provide your phone number

Please provide your email address

You are required to remain up to date with your water bill payments. If after 60 days an account remains unpaid, the Township can transfer the unpaid balance to the property owner’s tax account for collection and apply an administration fee.

Yes

Please provide signature

Clear

Date of Notification