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Utility Service Account Change Form

  1. City of Bainbridge Island - Utility Service Change Form

    Use this form if you are starting or stopping utility service at an established, existing service address.

    Once the following information is submitted, Utility Billing will contact you at the contact information provided to confirm the change to service. If you have questions, please contact Utility Billing at (206) 780-8603 or finance@bainbridgewa.gov.

    Note: If you need to set up a new billing account for a service address that is not an established, existing service address (for example, if the service address is part of a new development), please complete a New Utility Connection application.

  2. Section I. Change Information
    Complete the following fields to start or stop utility service at an established, existing service address.
  3. Please indicate the date the change is to be effective.
  4. Type of Change Requested:
    Please select if you want to start or stop utility service.
  5. (Owners are copied on delinquent accounts.)

  6. Please enter the address address of the property receiving utility service. Note: All service addresses are on Bainbridge Island.
  7. Section II. Billing/Forwarding Information
  8. A mailing address for billing/final billing is required.
  9. Please provide an email address for your account.
  10. Optional: If you prefer, you may connect a second email address to your account.
  11. One valid phone number is required to set up your account.
  12. Optional: If you prefer, you may connect a second phone number to your account.
  13. Use this space to include any comments, questions, or instructions to Utility Billing.
  14. Leave This Blank:

  15. This field is not part of the form submission.