Request New Service
This form is for residential accounts only. Please
contact us
for non-residential accounts.
Required entry
General Information
Your Name:
Start Date:
Meter will be read within 3 business days.
Primary Account Holder
Name:
Prefix :
[Select]
Mr.
Ms.
Mrs.
SSN or DL #:
(or)
At least one is required
By checking this box, I agree to a soft credit check on my SSN.
Primary Phone:
(
)
-
Business Phone:
(
)
-
Email Address:
Employer:
Secondary Account Holder - Legal Spouse
To add a secondary account holder that is NOT a legal spouse, skip this section and contact TMWA customer service at (775) 834-8080.
Name:
Prefix :
[Select]
Mr.
Ms.
Mrs.
SSN or DL #:
(or)
Primary Phone:
(
)
-
Business Phone:
(
)
-
Employer:
Requested Service Address
Establish Service at this address
Service Address:
Apt/Lot/Unit #:
Unit Description:
City:
State:
[Select]
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
Zip/Postal Code:
Mailing Address
Required entry when completing this section.
Mailing Address and Service Address are the same
Mailing Address:
Apt/Lot/Unit #:
Unit Description:
City:
Country:
USA
Mexico
Canada
State:
[Select]
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
[Select]
AG
BC
BS
CH
CL
CM
CO
CS
DF
DG
GR
GT
HG
JA
MI
MO
MX
NA
NL
OA
PU
QR
QT
SI
SL
SO
TB
TL
TM
VE
YU
ZA
[Select]
AB
BC
MB
SK
NB
NL
NS
ON
PE
QC
Zip/Postal Code:
Additional Information
Are you a current TMWA customer?
Current
Previous
New Customer
Special instructions or additional information that you feel we need to be aware of:
By submitting this information, I agree to place the requested service in my name.
 
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