Coxsackie, NY · Greene County
Water and Sewer E-Billing Registration Form
Water and sewer customers use this form to register accounts for bill notifications by email, with the option to keep receiving paper bills.
What this form is
This form lets Village of Coxsackie water and sewer customers choose email bill notifications, either instead of paper bills or alongside them. To sign up, provide the customer name, utility account number, service and mailing addresses, contact details, email address, and bill-delivery preference, then sign and date the form. The document says customers may register more than one account and that e-billing does not change payment options.
Who needs it
Village of Coxsackie water and sewer customers who want email bill notifications use this form to register one or more billing accounts.
How to submit it
Return the completed authorization form or email your full name, address, and account number to [email protected]. The form also lists the Village Office phone number, (518) 731-2718.
About notarization
This document is signed and dated without a notary; it does not identify any attachment or related step that must be notarized or sworn.
How to submit this form
- 1
Download The Form
Download the Water and Sewer E-Billing Registration Form.
- 2
Complete The Form
Enter your customer and account details, contact information, and email address; mark your bill-delivery preference.
- 3
Sign And Date
Sign and date the registration form.
- 4
Submit To The Village
Return the form or email your full name, address, and account number to [email protected].
Frequently asked questions
- Do I need a notary for the Water and Sewer E-Billing Registration Form?
- No. The form asks the customer to sign and date it, and does not identify any attachment or related step that must be notarized or sworn.
- How do I submit the Water and Sewer E-Billing Registration Form?
- Return the completed authorization form or email your full name, address, and account number to [email protected].
- Can I receive both e-bills and paper bills?
- Yes. The form offers a choice between e-bill only and both e-bill and paper bill. Mark your preference with an X.
- What information does the registration form request?
- It requests your name, utility account number, service and mailing addresses, contact details, email address, bill-delivery preference, signature, and date.
Need something notarized?
This Water and Sewer E-Billing Registration Form doesn’t need a notary — but if you have another Coxsackie form that does, a commissioned online notary can help.