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Account Maintenance Request Form

  1. Type of Change*

  2. Information About You

  3. Documentation Provided*

    Please scan in or take a picture of document and email it to utilities@bullardtexas.net

  4. Electronic Signature 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.

  5. Leave This Blank:

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