Do You Own or Rent? Own Rent Proof of Ownership upload real estate tax document, closing documents, deed, or mortgage statementFiles must be less than 20 MB.Allowed file types: gif jpg jpeg png txt html pdf doc xls xlsx. Attach a copy of your rental/lease agreement Files must be less than 20 MB.Allowed file types: gif jpg jpeg png txt html pdf doc xls xlsx. Is this for commercial or residential service? Residential Commercial Commercial Service Information Requested Date of Service Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year2003200420052006200720082009201020112012201320142015201620172018201920202021202220232024202520262027202820292030203120322033 Total Connected Load of All Gas Appliances and Equipment in BTU's Required Service Pressure (in W.C. or PSI) Length of Downstream Piping (from meter to appliances) Size of Downstream Piping (diameter) The above information will determine sizing of meter and regulator. Some equipment (meters/regulators) have long lead time of up to 8 weeks. If existing service is inactive for over 12 months, a new pressure test is required before re-activating service. Customer is responsible for locating and marking customer owned utilities prior to CU performing any excavation. Customer is responsible for moving any obstructions at the site. Landlord's Name First Name Middle Name Last Name Maiden Name Business Name Service Street Address with City, State, and Zip Mailing Address with City, State, and Zip Phone Number Social Security # Drivers License Attach photo of Drivers License Files must be less than 6 MB.Allowed file types: gif jpg jpeg png. Fed. Tax ID# Date of Birth Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year18731874187518761877187818791880188118821883188418851886188718881889189018911892189318941895189618971898189919001901190219031904190519061907190819091910191119121913191419151916191719181919192019211922192319241925192619271928192919301931193219331934193519361937193819391940194119421943194419451946194719481949195019511952195319541955195619571958195919601961196219631964196519661967196819691970197119721973197419751976197719781979198019811982198319841985198619871988198919901991199219931994199519961997199819992000200120022003200420052006200720082009201020112012201320142015201620172018201920202021202220232024202520262027202820292030203120322033 Spouse's Name Employer Applicant Signature By signing below, I ask that an account be opened for me. I understand that you may verify and exchange usage and cost information on me. Personal information will be protected and only released upon written request from applicant. I will be bound by the Agreement received. If this is a personal account, I agree, or if this is a corporate account, both I and the company agree to be liable for all charges.Your Deposit will be refunded in one year if account is paid by due date. The Deposit will not be applied or refunded before one year unless the account is closed.It is also understood that when the service is turned off for nonpayment of bill, or whenever for any reason beyond control of Carrollton Utilities a re-establishment of service is required by any one customer, a service charge must be paid to Carrollton Utilities to cover a part of the cost of discontinuance and re-establishment of service (see rules and regulations). Customers with only sanitary sewer service can be charged additional fees for reconnection due to non-payment based on agreements with the water district supplying water service.I have read the "rules and regulations" for customer service and agree to abide by them. Employer's Phone # Previous Address Leave this field blank