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2. PLEASE READ CAREFULLY

   Please complete the following residential application to start City utility services. A $150.00 security deposit is required to complete account setup. Online payment is collected through a secure Wells Fargo payment site. You will be redirected once this form is submitted. Please enter the full service address in the "Reference" field. 

6. First*
7. Middle Initial
8. Last*
9. Phone*
11. Spouse First
12. Middle Initial
13. Last
14. Phone
16. Service Address*

    Use service address as reference when paying deposit

18. Mailing Address (If different than service address)
20. City
21. State
22. Zip
24. Rent or Own?*

    1. Rent
    2. Own
25. Closing Date
    Closing Date
26. Rental Date
    Rental Date
28. Name of Landlord
30. Paperless Billing?

    1. Yes
    2. No
32. Email Address*
34. Text Notifications?

    Only used for late notices and special utility reminders

    1. Yes
    2. No
36. Preferred Phone Number for Text
38. Signature*
    By typing your name into the field available you are hereby authorizing Spearfish, South Dakota to accept this as your electronic signature.
39. Date*
    Date
41. Fair & Accurate Credit Transactions Act
    To abide by the Fair and Accurate Credit Transactions Act, the City of Spearfish will only allow the applicant(s) listed to make changes and make billing inquiries on this account.
Leave This Blank:


43. 1. Receive an email copy of this form.
44. Email address

    This field is not part of the form submission.

45. Submit

* indicates a required field