Jeffersonville, GA · Twiggs County
Water Service Application
Jeffersonville residents use this application to request water, sewerage, or another service and provide applicant, property, and billing details.
What this form is
The Water Service Application is for requesting water, sewerage, or another specified service from the City of Jeffersonville. It asks for the applicant’s name, Social Security Number, property and billing addresses, requested service, telephone number, and signature and date. The form also includes office-use fields for account, service, and deposit information, plus optional demographic information.
Who needs it
A person applying to the City of Jeffersonville for water, sewerage, or another service should complete this application.
How to submit it
Submit it to the city department named on the form; check the city website for current contact details.
About notarization
This application is signed and dated without a notary; the applicant just signs and dates it.
How to submit this form
- 1
Download The Application
Download the Water Service Application PDF.
- 2
Complete The Applicant Fields
Enter the requested name, Social Security Number, addresses, service type, and telephone number.
- 3
Review And Sign
Review the application, then sign and date it. The form does not list required attachments.
- 4
Submit To The City
Submit it to the city department named on the form; check the city website for current contact details.
Frequently asked questions
- What services can I request with the Water Service Application?
- The form lists water and sewerage as service options, and it also provides an “Other” option where the applicant can specify a service.
- What information does the Water Service Application ask for?
- It asks for the applicant’s name, Social Security Number, property and billing addresses, requested service, telephone number, and signature and date.
- Do I need a notary for the Water Service Application?
- No. The application has a signature and date field and no notary block; the applicant just signs and dates it.
- How do I submit the Water Service Application?
- The form lists the City of Jeffersonville at 18 N. Church Street, Jeffersonville, GA 30144, but does not give submission instructions. Check the city website for current contact details.
Need something notarized?
This Water Service Application doesn’t need a notary — but if you have another Jeffersonville form that does, a commissioned online notary can help.