Water/Sewer/Gas Utility Application

Please complete every section. You must provide your driver's license and lease/rental agreement. You will sign the utility policy electronically.

1. Applicant
2. Contacts
3. Policy
4. Documents

Section 1 of 4: Applicant information

Fields marked with an asterisk are required.

City of Colquitt Water/Sewer/Gas Utility Application and Utility Policy City of Colquitt, 154 West St., Colquitt, GA 39837, (229) 758-1000 ext. 221 YOU MUST PROVIDE DRIVER’S LICENSE AND LEASE/RENTAL AGREEMENT

Name

Phone number

Address

Mailing address (if different)

Date of birth

Encrypted on the server. It is not included in the notification email.

Social Security number

Encrypted on the server. It is not included in the notification email.

License number

Encrypted on the server.

Need help or a paper copy of a form? Call City Hall at (229) 758-1000 or visit us at 154 West St, Colquitt, GA 39837. Applicants requiring reasonable accommodations should contact the Human Resources Department.

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