Account# _________________________________________ Deposit E-Billing
Call Center# _________________________________________ Admin Fee Same-day Fee
** A copy of the account holder's driver's license is required for all new service requests**
Name:
Phone:
E-mail:
Date to Connect (Normal Business Day): ____________________________ Tax ID #: __________________________
Valid Driver's License: State: ___________________ Number: _________________________________________
_________
_________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
Last
First
M
NEW SERVICE
Home Phone
Business Phone
Cell Phone
Street
City/State
Zip Code
Street
City/State
Zip Code
__________________________________________________________________________________________________
I hereby request confidentiality of my personal information by the City of Frisco’s
Utility Billing Division.
I hereby withdraw my request for confidentiality.
SIGNATURE OF CUSTOMER
DATE