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  1. 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.
  2. Enter the date you want this request to become effective.
  3. Please enter the name that is currently on the account.
  4. Please enter the BWA account number
  5. Enter the service address for this account.
  6. Please upload a copy of the current account holder's valid government-issued photo ID.
  7. Please enter the new name for the account.
  8. Please enter a good contact phone number for the new account holder.
  9. Please upload a copy of the new account holder's valid government-issued photo ID.
  10. Rental Properties
    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.
  11. 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.
  12. Leave This Blank:

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