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Name Change Form
This form has been modified since it was saved. Please review all fields before submitting.
Use this form to change the name on an account due to marriage or divorce. If the current account holder is deceased the name on the account cannot be changed. A new account must be established with the new name using the New Service Application form.
Enter the date you want this request to become effective.
Current Name on Account
Please enter the name that is currently on the account.
Please enter the BWA account number
Enter the service address for this account.
Current account holder ID
Please upload a copy of the current account holder's valid government-issued photo ID.
New Account Name
Please enter the new name for the account.
New account holder phone number
Please enter a good contact phone number for the new account holder.
New account holder ID
Please upload a copy of the new account holder's valid government-issued photo ID.
If this is a rental property, we may request a copy of the current lease, which must include the name of the new account holder. A BWA representative will contact you if this is needed.
Electronic Signature Acknowledgement
By checking the "I agree" box below, you agree and acknowledge that 1) your Name Change Request will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.
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