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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)
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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