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Request for New Water/Sewer Service Account
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Please complete this form to establish a new Village of Northfield water and/or sewer service account. Knowingly providing incorrect or false information invalidates this form and may constitute fraud.
Date to Establish Service
Billing Address (if different than service address)
Billing City, State, Zip (if different than service address)
If this is a rental property, provide the name and address of the property owner or management company
Upload a legible copy of your current driver's license or alternate government-issued photo ID
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(DOC, DOCX, XLS, XLSX, TXT)
By electronically signing and submitting this form, I recognize that I am assuming the payment responsibility for this utility account from the date provided forward.
Signature of New Responsible Party
* indicates required fields.
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