Keene, TX · Johnson County
Extension Request Form
Keene utility customers use this form to request an extension for an amount due and provide their account, service, and contact information.
What this form is
This form lets a Keene utility customer request an extension for an amount due and provide the requested payment due date. It asks for the customer’s name, account number, service address, telephone number, email, amount due, and signature and date. The form says extensions are allowed once every six months and describes consequences if the customer defaults or does not pay within five calendar days.
Who needs it
A Keene utility customer seeking an extension for an amount due should complete and return this form to City Hall.
How to submit it
Return the completed form to Keene City Hall at 1000 N. Old Betsy Rd, Cleburne, Texas 76031; the form also lists fax 817-556-2060 and [email protected].
About notarization
This form has no notary block, so the customer signs and dates it; it does not identify any notarized attachment or related step.
How to submit this form
- 1
Download The Form
Download the Keene Extension Request Form PDF.
- 2
Complete The Form
Enter your name, account number, service address, telephone, email, amount due, and requested due date.
- 3
Sign And Date
Sign and date the form in the customer signature section.
- 4
Submit To The City
Return the completed form to Keene City Hall, or use the fax or email listed on the form.
Frequently asked questions
- What is the Extension Request Form for?
- Keene utility customers use it to request an extension for an amount due and provide their account information, requested due date, signature, and date.
- Who can request an extension with this form?
- The form is for a utility customer requesting an extension for an amount due. It says extensions are allowed once every six months.
- How do I submit the Extension Request Form?
- Return it to Keene City Hall at 1000 N. Old Betsy Rd, Cleburne, Texas 76031. The form also lists fax and email submission options.
- Do I need a notary for the Extension Request Form?
- No. The form has no notary block; the customer signs and dates it, and it does not identify a notarized attachment or related step.
Need something notarized?
This Extension Request Form doesn’t need a notary — but Texas residents can notarize other documents online with a commissioned online notary.