Utility Service Request - City of Atchison

Services *

Get Residential Service
Get Business Service
Move Service
Disconnect Service

Current Street address *

New Atchison Street Address *

Address to disconnect *

New Atchison Street Address *

Hidden

Date of Submission *

Requested Start Date for Service *

(Sorry we do not connect services on weekend or city holidays. If you select a start date on a non-service day, we will suggest an alternative service start date in your email confirmation.)

Requested Disconnect Date *

(Sorry we do not connect services on weekend or city holidays. If you select a start date on a non-service day, we will suggest an alternative service start date in your email confirmation.)

Business Name *

Name *

Last Name | First Name | Middle Initial

Date of Birth *

Email *

Enter Email Confirm Email

Phone *

(We will contact you at this number to confirm your request)

Phone Type *

Present Employer *

Work Phone

SSN *

Driver's License # or ID # *

State *

Previous Street Address *

Street Address | City | State | Zip Code

Forwarding mailing address *

Street Address | City | State | Zip Code

Requested Date to turn off:

Federal ID #

Mailing Address *

Street Address | City | State | Zip Code

Additional information