Utility Service Request

Welcome to Atchison, we're glad to have you! The City of Atchison provides water, wastewater, and CSO services. All three services are conveniently bundled in one monthly statement -- your City of Atchison utility bill.

Services * Required
- Get Residential Service
- Get Business Service
- Move Service
- Disconnect Service
Current Street address * Required
New Atchison Street Address * Required
Address to disconnect * Required
New Atchison Street Address * Required
Hidden
Date of Submission - must be mm/dd/yyyy format * Required
MM slash DD slash YYYY
Requested Start Date for Service - must be mm/dd/yyyy format * Required
(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.)
MM slash DD slash YYYY
Requested Disconnect Date - must be mm/dd/yyyy format * Required
MM slash DD slash YYYY

(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 * Required
Name * Required

Last Name | First Name | Middle Initial
Date of Birth - must be mm/dd/yyyy format * Required
MM slash DD slash YYYY
Email * Required
Enter Email Confirm Email
Phone * Required
We will contact you at this number to confirm your request. This request will not be processed until we contact the customer
Phone Type * Required
Present Employer * Required
Work Phone
SSN * Required
Driver's License # or ID # * Required
State * Required
Previous Street Address * Required

Street Address | City | State | Zip Code
Forwarding mailing address * Required

Street Address | City | State | Zip Code
Requested Date to turn off: - must be mm/dd/yyyy format
MM slash DD slash YYYY
Federal ID #
Mailing Address * Required

Street Address | City | State | Zip Code
Additional information