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2. 
4. GENERAL INFORMATION

   Please complete this form to sign up for paperless ebill. Please contact the Water Department directly with any questions or concerns at 313-387-2670.

6. Name*
8. Address*
10. City*
11. State*
12. Zip Code*
14. Telephone Number*
15. Email Address*
19. SIGN UP FOR PAPERLESS BILLING*

    Residents and businesses who sign up for this option receive emailed water bills every two months.  Please select YES or NO below.

    After completing this form, you must click submit (or submit and print) at bottom of page.

    1. YES - Sign up to receive emailed paperless water bills.
    2. NO - Not interested in paperless billing at this time.
21. Water Bill Customer Account Number*
22. Send Paperless Bill to the Following Email Address*
26. Resident or Business*

    1. Residence
    2. Business

    Please indicate if this is for a residence or business.

28. If you are not the property owner for which the paperless billing is associated, provide the following information.
30. Name of Landlord
31. Landlord's Email Address (if available)
33. Landlord's Telephone Number
39. CAN WE HELP YOU WITH SOMETHING ELSE?*
    -- Select One --Request a call back to discuss paperless billing options.

    Would you like for one of our team members to contact you to discuss paperless billing? 

Leave This Blank:


40. 1. Receive an email copy of this form.
41. Email address

    This field is not part of the form submission.

42. Submit Submit and Print

* indicates a required field