Utility Account Contact Information Form

Print Feedback

Font Size: + -

Please correct the fields below:

Please correct the field(s) marked in red below:

Please use the form below to submit the contact information for your utility account (garbage & water) in the City of Roswell.

If you have any questions, please contact the Financial Services Division at fsd@roswellgov.com or 770-641-3759.

Contact Information

*

Contact Information

Customer Name:

Service Address:

Mailing Address (if different than service address):

Phone:ext.

Email:

*

Signature (Please type your full name in lieu of your signature):

Date:

To receive a copy of your submission, please fill out your email address below and submit.
Email Address