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 and any other debt owed to the City including court judgments and fines; 3. 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; 4. Residential sanitation charges are mandatory within the City limits except for vacant rental property in an approved Landlordís name; 5. The City may access my credit information and verify employment for the purposes of determining my deposit and collecting unpaid amounts, 6. Any debt owed to the City of LaGrange including but not limited to court judgments and fines shall be paid prior to obtaining utility service, 7. Applicants with delinquent amounts owed to the City of any type shall be subject to having utility services terminated for failure to pay said debts, 8. The City shall not be responsible for the transmission or use of utility services beyond the Applicantís meters.

Please fax a copy of your lease or purchase agreement plus a photo ID to our Customer Service office at 706-883-2041 or email this information to utilities@lagrange.net 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
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)