Coahoma, TX · Howard County
Water Application and Service Agreement
Coahoma residents and businesses use this application and agreement to request water and sewer service and provide account and service-address information.
What this form is
The City of Coahoma uses this application and agreement for residential and commercial water and sewer service. Applicants provide contact, service-address, dwelling, and account information, list adult occupants, and sign terms addressing contamination protection, inspections, backflow devices, and payment. The document also includes a customer service inspection agreement and a separate section for requesting or canceling confidentiality of personal information.
Who needs it
Residents or businesses applying for water or sewer service at a Coahoma address need to complete and sign the application and service agreement.
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; the applicant signs and dates the agreement, and the confidentiality request and customer service inspection agreement also have signature and date lines.
How to submit this form
- 1
Download The Application
Download the Water Application and Service Agreement PDF.
- 2
Complete The Application
Provide the requested applicant, contact, service-address, dwelling, and adult-occupant information.
- 3
Review And Sign
Review the service and contamination-protection agreements, then sign and date the applicable sections.
- 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
- Do I need a notary for the Water Application and Service Agreement?
- No. This document has signature and date lines, but no notary block. The confidentiality request and customer service inspection agreement also have signature and date lines.
- Who uses the Coahoma water service application?
- Residents or businesses applying for residential or commercial water and sewer service at a Coahoma service address use this application and agreement.
- What information does the application ask for?
- It asks for applicant and contact details, the service and mailing addresses, dwelling type, adult occupants, and account information. It also includes service agreements and a confidentiality request section.
- How do I submit the water application?
- Submit it to the city department named on the form; check the city website for current contact details.