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2. Thank you for completing the online form to set up a Payment Plan for City Utilities.

   Please note: Submitting this form does not indicate that you are signed up for a Payment Plan. City staff will reach out to you with additional information and ask that you have a signed agreement on file.

   Payment Plan durations are available for past due balances as detailed below:

   $500 - $1,000 - 6 Months

   $1,000 - $2,000 - 12 Months

   $2,000 - $4,000 - 18 Months

   $4,000 and above - 24 Months

4. Name*
5. Email
7. Service Address*
9. Utility Account Number
10. Phone Number*
12. By typing my full name, I agree to start the process of setting up a Payment Plan for my City Utilities. I understand that submission of this form does not indicate that I have a Payment Plan in place, and City staff will contact me to set up a plan. I also understand that I must have a signed agreement on file and acknowledge the payment terms that are available.*
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14. 1. Receive an email copy of this form.
15. Email address

    This field is not part of the form submission.

16. Submit

* indicates a required field