Utility Services Request

The City may provide any or all of the following services at your location:

Water, Electricity, Sewer, or Refuse.

Check with your landlord or realtor to determine which city services are available at your location.

Please Note the Following About Online Service Requests

Due to system constraints, requests cannot be made more than 30 days in advance.
Applications are processed during regular customer service hours only:
Mon - Fri, 8 a.m. - 5 p.m. (Except observed holidays)
Service requests dates cannot fall on weekends or observed holidays.
For Same Day Service, applications must be submitted by 3 p.m.
(A $15 Same Day Service fee will be applied)
If you submit an application after 3 p.m. for service on the next business day, it is considered a Same Day Service request.
During student rush periods: June, July, and August, Same Day Service is unavailable.
Online applications cannot be processed if you have a PAST DUE account, or if there is a PAST DUE account at the requested service address. To schedule services, you will need to stop by Utility Customer Services at 701 E. Broadway (at the corner of 8th Street and Broadway).

To sign-up for services, please submit the following information. * Indicates Required Field

Select Request Type: Start New Service Stop Existing Service Transfer Existing Service
Request Date:** (mm/dd/yyyy)	*

Stop Services at Old Location On:
(Only if different from Request Date)

**The City of Columbia cannot guarantee services on the dates requested on this form. Please check your confirmation for actual date scheduled.
If you absolutely require a services on a specific date, please sign-up by phone at (573) 874‑7380. Customer Service Reps will work with you to determine an available date.

Customer Information

First Name:	*
Middle Initial:
Last Name:	*
Date of Birth: (mm/dd/yyyy)	*
US Resident?	Yes: No: *
Social Security Number: (without dashes) Visa Number: (Note: F1 is a type of Visa, not its number)	*
All phone numbers should be 10 digits including Area Code (enter numbers only)
Phone: (Day)	*
Phone: (Evening)	*
Fax: (Required for fax confirmation)
E-mail: (Required for email confirmation)
Employer:	*
Additional Persons Allowed to Contact Customer Service Concerning this Account If you do not enter any names here, no one else will be able to contact customer service on your behalf.
Spouse:
Roommate/Other:

Permanent/Current Address Information

Existing Service Address Information

Account No: (From your bill)

House Number:	*
Street Direction: (N,S,E,W...)
Street Name:	*
Street Type: (St., Dr., Ct....)
Apt/Suite #:
Zip: (City/State obtained from Zip)	* *

New Service Address Information

Final Billing Address Information

House Number:	*
Street Direction: (N,S,E,W...)
Street Name:	*
Street Type: (St., Dr., Ct....)
Apt/Suite #:
Zip: (City/State obtained from Zip)	* *

Special Instructions for Customer Services:
Please use the space above to provide any additional information/instructions, such as an alternate billing address, pet concerns, etc...

To receive a confirmation that this request has been processed, choose one of the following notification methods.

If you have not received a confirmation by the end of the next business day, please call Customer Services at (573) 874‑7380 to inquire about the status of your online application. (email and fax only, for US Mail allow up to 5 business days)

Mail: Email: Fax:

Mail responses will be sent to the Permanent/Current Address entered above. Mail responses will be sent to the Existing Service Address entered above.

Note: If Submit button is disabled, you need to scroll up and select the Service Request Type (Start, Stop, Transfer)