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Commercial Application for Utility Services PCI

  1. City of Pilot Point Commercial Application for Utility Services
    Please complete the following application to have services connected or transferred.
  2. Service calls are made between 3:00PM-5:00PM on the requested start date. It is REQUIRED that someone be at the residence at the time of connection due to the possibility of an outlet being open. An open outlet can cause flooding of the premises.
  3. ***Please See Planning Department upon requirement of Certificate of Occupancy***
  4. Primary Contact
  5. Mailing Address
    Is your mailing address the same as your service address?
  6. Bill Delivery*
    How would you like to receive your monthly utility bill?
  7. Photo Identification
    Please submit a copy of your driver license by fax to 940-686-4338, or drop off at City Hall 102 E. Main St., Pilot Point TX, 76258.
  8. Transfer
    Would you like to transfer service from another location in Pilot Point?
  9. Please provide the service address for the account you would like to transfer from.
  10. Service History *
    Have you previously had service in the City of Pilot Point?
  11. Please provide the service address for any account you have had with the City of Pilot Point.
  12. Secondary Contact
  13. Emergency Contact
  14. Would you like to set up Auto Payment?*
  15. Confidential Request
  16. By signing above, I agree to applicable service connect fees and understand my monthly bill is due on or before 5:00 PM on the 5th of every month. Payments received after 5:00 PM on the 5th will incur a 10% late charge fee. Payments received after the 15th of the month are subject to disconnection and applicable fees. See service agreement for service fee amounts and additional charges and fees for service.
  17. I have read and understand the City of Pilot Point Service Agreement and Terms of Service Agreement.
  18. Leave This Blank:

  19. This field is not part of the form submission.