Baytown, TX · Harris County
Customer Release of Information Authorization Form
The Customer Release of Information Authorization Form lets Baytown utility customers authorize account-information disclosure or rescind a prior disclosure request.
What this form is
This form lets a City of Baytown utility account holder authorize disclosure of account information, including usage, services, and billing, or rescind a previous disclosure request. The holder provides account and contact details, checks the applicable box, and signs and dates the form. The document says to disregard it if the customer wants privacy to remain on the account.
Who needs it
Baytown utility account holders who want to authorize disclosure of account information or rescind a previous disclosure request need this form.
How to submit it
Return the completed form to the Utility Billing Office at 2505 Market St., Baytown, TX 77520, or email it to Customer Service at [email protected].
About notarization
This form is signed and dated without a notary; it does not request a notarized or sworn attachment.
How to submit this form
- 1
Download The Form
Download the Customer Release of Information Authorization Form.
- 2
Complete Account Details
Enter the account holder name, account number, service address, telephone number, and email address.
- 3
Choose And Sign
Check the box to authorize disclosure or rescind a previous request, then sign and date the form.
- 4
Submit To The City
Return the form to the Utility Billing Office at 2505 Market St. or email it to Customer Service.
Frequently asked questions
- What does the Customer Release of Information Authorization Form do?
- It lets a Baytown utility account holder authorize disclosure of account information, including usage, services, and billing, or rescind a previous disclosure request.
- Who should complete this Baytown form?
- The utility account holder should fill in the account and contact information, check the applicable disclosure or rescission box, and sign and date the form.
- Do I need a notary for the Customer Release of Information Authorization Form?
- No. The form is signed and dated without a notary, and it does not request a notarized or sworn attachment.
- How do I submit the Customer Release of Information Authorization Form?
- Return it to the Utility Billing Office at 2505 Market St., Baytown, TX 77520, or email it to Customer Service at [email protected].
Need something notarized?
This Customer Release of Information Authorization Form doesn’t need a notary — but Texas residents can notarize other documents online with a commissioned online notary.