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Request to Transfer Service
Primary Applicant
Is there another person living in the home other than the primary applicant?
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Yes
No
Primary Applicant First Name
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Primary Applicant Last Name
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Date of Birth
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Driver's license number
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Last 4 digits of social security number
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Phone Number
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Email Address
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Are you currently enrolled in our monthly automatic bank draft?
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Yes
No
Do you want to transfer your existing Bank Drafting to the new address?
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Yes
No
Additional Applicant
First Name
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Last Name
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Date of Birth
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Date of Birth
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Driver's license number
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Last 4 digits of social security number
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Phone Number
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Email Address
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New Address Information
Are you a
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Property Owner
Renter
Property Manager/Realtor
Requested Start Date at New Address
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New Service Street Address
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City
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State
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Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Washington DC
Zip Code
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Do you wish to receive your bill through e-mail?
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Yes
No
Billing Address
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City
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State
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Zip Code
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Do you want to enroll in automatic payments using bank drafting?
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Yes
No
Termination Requested for Previous Address
Requested Termination Date
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Street Address
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Forwarding Address
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City
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State
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Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Washington DC
Zip Code
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Automatic Bank Drafting Options
Enrollment in bank drafting means that the full amount due for my utility bill each month will be drafted automatically from the bank information provided on the account's due date. If the payment is rejected for any reason, the account will be subject to additional fees and delinquency efforts. If the bank information changes and the City of League City is not notified, the account is subject to additional fees and delinquency efforts. Maintaining up-to-date information is the sole responsibility of the account holder.
Bank Name
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Routing Number
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Bank Account Number
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Picture or copy of a voided check
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Terms & Conditions
Please review and sign each item.
I understand that I will receive a final bill to my forwarding address listed above. If payment is not received within 30 days on my final bill, the remaining balance will be transferred to my new account and subject to delinquency efforts.
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clear
I understand that any deposit paid on my previous account will be applied to the final bill. Any credit remaining after the application of my deposit will be mailed to my forwarding address in the form of a paper check.
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clear
I understand that I will be required to pay a new deposit on my new account. The deposit will appear on my first statement for my new service address.
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clear
I understand that by enrolling in bank drafting, I am authorizing the City of League City to automatically pull the full amount due on my account each month on the designated due date. Furthermore, I understand that I am responsible for supplying current and accurate information to the City of League City. If my payment is rejected for any reason, I understand that my account will be subject to additional fees and delinquency efforts.
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clear
Required Documentation
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