TRANSFER SERVICE APPLICATION


Ames Municipal Utilities Online Customer Service

Applicant Information
First Name    
Middle Initial  
Last Name    
Date of Birth (click on date from calendar)      
Social Security Number (xxx-xx-xxxx)      
Driver's License Number  
Driver's License State  
Employer  
Work Telephone  
Are you Married?    
 
 
 
Your Ames Municipal Utilities Account Number:
(your account number is printed on your bill)
   
 
Date you want service to stop:           Date you want service to begin:        
Dates available are Monday through Friday, excluding Holidays. A requested date may be changed up to two (2) work days to coincide with an existing request or if the date is not a normal work day.
 
 
Present Service Address Information
Street Address    
Apt. Lot or Unit Number  
City    
State  
Zip Code    
 
New Service Address Information
Street Address    
Apt. Lot or Unit Number  
City    
State  
Zip Code    
Do you want your utility bill mailed to an address other than your service address?   
 
 
Other Information
Current Phone Number    
Will this be your telephone number at your new address?   
E-mail Address      
Will You Own or Rent?    
Landlord's Name    
Landlord's Telephone  
 
In Case of an Emergency
Contact's Name    
Contact's Address    
Contact's City    
Contact's State  
Contact's Zip Code    
Contact's Telephone  
 
 
Your payment history will be reviewed to determine if a new or additional deposit is required. If a new or additional deposit is required, then it will be billed to your account.
 
Additional Comments
* 500 character maximum