Online Application for New Utility Service
  
By submitting this application, Applicant acknowledges: 1. The above information is true and correct to the best of my knowledge (City Code Section 20-1-11 states that it is unlawful for any person to obtain utility service by deceitful means or artful practice which includes providing false information during the application process); 2. Applicant will pay all applicable utility charges and fees for service at the above location; 3. Any past due amounts from previous utility services will be paid prior to obtaining new utility services; 4. Penalties may be charged for late payment, and service will be discontinued for failure to pay all charges by the due date shown on monthly statements; 5. Residential sanitation charges are mandatory within the City limits regardless of actual use of this service except for vacant rental property in an approved Landlord’s name; 6. If provided, the City may utilize my social security number or ITIN and other information to determine my credit score and verify employment for the purposes of determining my deposit and collecting unpaid amounts. Should I choose not to provide my social security number or ITIN, I understand that I will be charged the maximum deposit; 7. An unexpired picture ID issued by a State or federal government is required for identification purposes; 8. The City shall not be responsible for the transmission or use of utility services beyond the Applicant’s meters. 9. There are no open water or gas outlets within the building.

Please fax a copy of your lease or purchase agreement plus a picture ID to our Customer Service office at 706-883-2041 or email this information to utilities@lagrangega.gov or mail to Customer Service at 200 Ridley Ave, LaGrange, GA 30240.

Where in our service territory are you moving to?

 

Street Address
Apt/Unit Number
City
State
Zip Code
Rent or Own
Landlord Name (if renting)
Turn On Date (mm/dd/yyyy)


Where are you moving from?

 

Street Address
Apt/Unit Number
City
State
Zip Code
Turn Off Date (mm/dd/yyyy)
 if applicable


Personal Information

Utilities are billed in arrears, so a credit check is an important part of the application process.

 

Name
email address
Social Security Number or ITIN
Driver's License Number
Birthday (mm/dd/yyyy)
Primary Phone Number
Secondary Phone Number
Current Employer


Mailing Address

Please provide us with your mailing address if it will be different from your new service address.

 

Address
Apt/Unit
City
State
Zip Code


Comments
Please use the following fields for additional comments. (i.e. special instructions, or arrangements)