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2. Instructions

   All requests for utility account changes need to be submitted in writing to the Public Works & Utility Account Specialist. Community members can use the form below to submit any account changes.

   Note: The City of Milton requires residents to contact the Public Works & Utility Account Specialist at (608) 868-6900 ext. 1 with their driver license number or social security number in order to set up a new utility account. New accounts will not be activated until this information is received.

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4. Service Address*
6. Closing / Move Date*
8. Person Making Request
   -- Select One --Title CompanyCurrent Property Owner or TenantNew Property Owner or Tenant
12. Final Water Read Date
14. Purpose of Request
    -- Select One --Moving OutName or Mailing Address Change
16. New Name (Due to marriage, divorce, etc.)
    Changing the name on an account acknowledges that the new account holder is responsible for any previous balance on the account, as no meter read will be done for a name or mailing address change.
18. New Mailing Address
    Changing the mailing address on an account acknowledges that the new account holder is responsible for any previous balance on the account, as no meter read will be done for a name or mailing address change.
20. Title Company
21. Closer Name
23. Closer Phone Number
24. Closer Email
26. Current Account Holder
27. Phone Number (Current Account Holder)
29. Forwarding Address
31. New Property Owner / Tenant
32. Phone Number (New Property Owner / Tenant)
34. Realtor
35. Phone Number (Realtor)
37. Special Comments

39. If submitting this form via email, submission will be treated the same as signing this form. 
     
    If the closing or move in does not take place or the date changes, please notify the City of Milton in writing. 
     
    If submitting this form by email, the new tenant or owner needs to call the Public Works & Utility Account Specialist at (608) 868-6900 ext. 1 to provide their driver license or Social Security number to protect their privacy. 

Leave This Blank:


41. 1. Receive an email copy of this form.
42. Email address

    This field is not part of the form submission.

43. Submit Submit and Print

* indicates a required field