Enter the date for this change to take effect.
Please enter the name currently on the account.
Please enter the BWA account number.
Please enter the service address
Please upload a copy of the current account holder's valid government-issued photo ID.
Please enter the name you would like added to this account. For rental properties, only names of persons listed in the rental agreement may be added to the water account.
Please upload a copy of the additional 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 additional account holder. A BWA representative will contact you if this is needed.
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.
Enter your name.
This field is not part of the form submission.
* indicates a required field