St. Jacob, IL · Madison County
Utilities Application
This application lets people seeking utility service in St. Jacob provide account, contact, service-location, and customer information to the village.
What this form is
Use this application to request utility service from the Village of St. Jacob. It asks for the applicant’s name, service date and location, mailing address, phone and email, owner or renter status, and employment information; it also asks whether the applicant is a current utility customer. The form lists deposit amounts and payment terms, and includes a section for village staff.
Who needs it
People applying for utility service from the Village of St. Jacob should complete the applicant fields and sign and date the 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; it lists no notarized or sworn attachment, so the applicant just signs and dates it.
How to submit this form
- 1
Download The Application
Download the Village of St. Jacob Utilities Application.
- 2
Complete The Applicant Fields
Enter your contact and service information, indicate whether you are an owner or renter, and answer the current-customer question.
- 3
Review Deposit Information
Review the deposit information and payment terms printed on the application.
- 4
Sign And Submit
Sign and date the application, then submit it to the city department named on the form.
Frequently asked questions
- Do I need a notary for the Utilities Application?
- No. The application has a signature and date line but no notary block; it lists no notarized or sworn attachment, so the applicant just signs and dates it.
- How do I submit the Utilities Application?
- The form does not provide submission instructions. Submit it to the city department named on the form; check the city website for current contact details.
- What information does the application ask for?
- It asks for your name, service date and location, mailing address, phone and email, owner or renter status, employment information, and current customer status.
- What deposits are listed on the form?
- The form lists a $100 Water/Sewer/Trash Deposit, a $100 Water Deposit for water-only service outside village limits, and a $15 Sewer Deposit when Village Water is not used.