2. 
3. ***** Please disregard Form Center login above. *****
   Complete the information below if you are the new tenant of a residential or commercial property, and need to establish a new account for utility services.
5. A deposit of $150.00 is required for all non-owner accounts. Click on the link below to pay your deposit online, then

   RETURN TO THIS PAGE TO COMPLETE THE SIGN UP PROCESS.

7. XXXXXX
   CLICK HERE TO PAY $150.00 DEPOSIT ONLINE

   XXXXXX

11. Account Holder Name*
13. Service Address *
    (Please include your apartment or unit number, if there is one.)
14. Property Type:

    1. Residential
    2. Commercial
16. City*
17. State*
18. Zip Code*
20. MY MAILING ADDRESS IS:
22. Street Address*
    (Include apartment or unit number, if there is one.)
24. City*
25. State*
26. Zip Code*
28. Email Address*
29. Phone Number*
    (Please include area code.)
31. If the service property is commercial, please provide the Federal Tax ID Number:
33. Service Start Date*
    Service Start Date
35. THE START DATE CANNOT BE TODAY'S DATE. Please enter tomorrow's date or later.
    If you choose a date that is on a weekend or holiday, your start date will be scheduled for the following business day.
39. What is your landlord's name?
41. What is your landlord's phone number?
43. Please upload a copy of your lease agreement.*
    (If you are renting, or if you have a land contract, a copy of your contract MUST be submitted in order to establish service.)
45. Additional Comments:
49. WHAT HAPPENS NEXT?
    You may receive an email that states that your utility request has been submitted for review. This email IS NOT confirmation that your request is complete.
51. A representative of the Fairfield Utility Billing Office will contact you by phone to obtain your social security number, date of birth, and driver's license number.
53. After all information has been collected and processed, you will receive an email confirming that your utility transfer request has been completed. This confirmation email will also provide answers to common questions regarding your new Fairfield utilities account.
Leave This Blank:


55. 1. Receive an email copy of this form.
56. Email address

    This field is not part of the form submission.

57. Submit

* indicates a required field