RECEIPT NO ________________
ACCT NO ___________________
DATE ______________________
APPLICATION FOR COMMERCIAL WATER SERVICES
BUSINESS NAME ______________________________________________________________
SERVICE ADDRESS ____________________________ MAILING ADDRESS _______________
____________________________________________________________________________
TYPE OF BUSINESS _________________________________ PHONE NO ________________
MANAGER'S NAME ___________________________________ PHONE NO ________________
IN ORDER FOR WATER TO BE TURNED ON, ALL FAUCETS, ETC., MUST BE OFF. THE SERVICE PERSONNEL ARE NOT ALLOWED TO GO INSIDE THE BUILDING.
DATE OF SERVICE ____________________
SIGNATURE ___________________________
OFFICE USE ONLY
DL# _____________________
SS# _____________________
DOB _____________________
City of Roswell Post Office Box 1838 Roswell, New Mexico 88202-1838
(505) 624-6711 (505) 624-6709 - Facsimile