What changes can I request with this form?

The form provides space to describe requested utility account changes. If adding or removing a name, it also asks for that person’s name, date of birth, last four Social Security number digits, and employer details.

What information does the form require?

It asks for the utility account number, change start date, name on the account, service address, requested changes, and the account holder’s signature and date.

Do I need a notary for Utilities Account Changes?

No. This form has no notary block or sworn attachment; the account holder just signs and dates it.

LaGrange, OH · Lorain County

No notary required

Utilities Account Changes

LaGrange utility account holders use this form to request account changes, including adding or removing a name from the account.

What this form is

Use this form to request changes to a LaGrange utility account. It asks for the account number, change start date, account holder’s name, service address, requested changes, and, when adding or removing a name, that person’s details; the signer confirms continued responsibility for charges and usage.

Who needs it

LaGrange utility account holders who want to change account details, including adding or removing a name, can complete and sign this form.

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 document is signed without a notary; it lists no notarized or sworn attachment, so the account holder just signs and dates it.

How to submit this form

1
Download The Form
Download the LaGrange Utilities Account Changes PDF.
2
Complete Account Details
Enter the account number, change start date, account holder’s name, service address, and requested changes.
3
Add Name Details If Needed
If adding or removing a name, provide the requested details for that person.
4
Sign And Submit
The account holder signs and dates the form. Submit it to the city department named on the form.

Frequently asked questions

What changes can I request with this form?: The form provides space to describe requested utility account changes. If adding or removing a name, it also asks for that person’s name, date of birth, last four Social Security number digits, and employer details.
What information does the form require?: It asks for the utility account number, change start date, name on the account, service address, requested changes, and the account holder’s signature and date.
Do I need a notary for Utilities Account Changes?: No. This form has no notary block or sworn attachment; the account holder just signs and dates it.
How do I submit Utilities Account Changes?: Submit it to the city department named on the form; check the city website for current contact details.

Need something notarized?

This Utilities Account Changes doesn’t need a notary — but if you have another LaGrange form that does, a commissioned online notary can help.