Business Customer Registration

"*" indicates required fields

Legal Business Name*

DBA Name, if any

Service Area*

FEIN #*

Number of Employees on Site*

Address of Service*

Street Address Address Line 2 City State ZIP Code

Mailing Address (if different)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Nature of Business*

Billing Contact Name*

First Last

Billing Contact Phone*

Billing Contact Email*

Alternate Contact Name*

First Last

Alternate Contact Phone*

Alternate Contact Email*

Emergency Contact Name*

First Last

Emergency Contact Phone*

Emergency Contact Email*

Estimated Monthly Water Usage (gallons)*

Applicant Signature*

By signing below, I certify that the information provided in this application is true and accurate to the best of my knowledge. I acknowledge that I have read, understood, and agree to comply with all rules, regulations, and charges associated with the utility service. I understand that providing false or incomplete information may result in denial or termination of service.

Today's Date*

Business Customer Registration

Follow Our Social Media

Newsletter

Company

Residential

Business

Administration Office

Good Hope Lab

Alabaster Lab

Service & Operations

Mail Payments To:

Copyright © 2026 LW Utilities, LLC, All rights reserved.