2. UTILITY APPLICATION
   City of Kerrville, Texas
   701 Main Street
   Kerrville, Texas 78028
   830-258-1504
4. Online Utility Exchange Services will determine if account will require a deposit.
6. Service Start Date*
   Service Start Date
8. Address*
9. Apartment/Unit Number
11. City*
12. State*
13. Zip*
15. First Name*
16. Last Name*
18. Email Address*
19. Cell Phone*
20. Home Phone*
22. Employer
23. Work Phone
25. Mailing Address (if different from service address)
26. Apartment/Unit Number
28. City
29. State
30. Zip
32. Previous Address (if applicable)
33. Apartment/Unit Number
35. City
36. State
37. Zip
39. Personal Reference (if applicable)
40. Phone of Reference
44. Check if co-applicant is signing

    1. Yes
    2. No
46. Co-Applicant Name
47. Cell Phone
48. Home Phone
50. Email Address
52. Co-Applicant Address
53. Apartment/Unit Number
55. City
56. State
57. Zip
59. Employer
60. Work Phone
62. Co-Applicant Previous Address (if applicable)
63. Apartment/Unit Number
65. City
66. State
67. Zip
71. Check if applying for service at rental/lease property

    1. Yes
    2. No
73. Landlord Name
75. Landlord Address
76. Apartment/Unit Number
78. City
79. State
81. Email Address
82. Phone Number
83. Type of Property
    -- Select One --RentLeaseOwn
87. Check to recieve text messages

    1. Yes
    2. No
88. Check to sign up for e-billing

    1. Yes
    2. No
92. RIGHT OF CONFIDENTALITY:
    Each applicant hereby confirms their desire to keep their account information confidential.
94. Applicant check for electronic initials

    1. Yes
    2. No
95. Co-applicant check for electronic intials

    1. Yes
    2. No
Leave This Blank:


96. 1. Receive an email copy of this form.
97. Email address

    This field is not part of the form submission.

98. Submit

* indicates a required field