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City of Crestview
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Residential Utility Services Application

  1. Utility Billing Department Information Header
  2. Residential Services Request
  3. Application Must Be Received and Processed Before 3 p.m. for Same Day Service
  4. Is service address different from Billing
  5. Please upload a valid Photo ID
  6. Services unavailable on weekends and holidays.
  7. Services unavailable on weekends and holidays.
  8. Service Agreement*
    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date. The undersigned acknowledges that service is provided subject to adherence to the City of Crestview Terms and Conditions and services may be interrupted pursuant to any violation thereof. Undersigned also agrees to receive and pay for water, sewer and/or garbage service in accordance with the rates, rules and regulations until this service is formally discontinued.
  9. Applicant #2 (if applicable)
  10. Deposit Amount Due Upon Approval of Application*
  11. Funding Requirements for our USDA Loans require that we collect ethnicity information to document Nondiscrimination.
  12. Ethnicity
  13. Gender
  14. Final Bill Information
    Please allow 3 to 4 weeks for the final bill to arrive.
  15. Leave This Blank:

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