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2. City of De Soto Application for Utility Services: Water, Sewer, Trash/Recycling

   Complete the online form below to submit your application for water, sewer, and trash/recycling utilities. If you would like to contact us by phone, you may call (913) 583-1182.

   Please note: we require a valid driver's license number and social security number which will be sent with your application by email to our Utility Billing Department. If you prefer providing this information in person, please fill out the PDF application on the right, and bring into City Hall at 32905 W. 84th St. 

   
   

3. Utilities Application
   Utilities Application, Fillable PDF
7. Service Information
9. Date to Begin Service*
   Date to Begin Service

   (No Saturday or Sunday start dates; if a weekend date is selected, the start date will be moved to the closest business day.)

11. Service Address*
12. City, State, & Zip
14. Billing Options*

    1. Emailed Copy (Electronically)
    2. Hard Copy (Mailed)
15. Own or Rent?*

    1. Own
    2. Rent (if selected, please fill out landlord information)
17. Landlord Name
18. Landlord Phone Number
20. Landlord Address
21. Landlord City, State, & Zip
23. Customer Information
25. Billing Name*
26. Date of Birth*
    Date of Birth
28. Mailing Address*
29. City, State, & Zip*
31. Email Address*
32. Phone Number*
34. Social Security Number*

    Businesses: Use Tax ID Number

35. Driver's License Number*
36. Driver's License State*
38. Previous Address*
39. City, State, & Zip*
41. Place of Employment*
42. Work Phone Number*
44. Employment Address*
45. City, State, & Zip*
47. 2nd Customer Information
49. If you would like a second person on the bill, please complete the next section.
51. Name
52. Date of Birth
    Date of Birth
53. Relation
55. Email Address
56. Phone Number
58. Social Security Number
59. Driver's License Number
60. Driver's License State
62. Place of Employment
63. Work Phone Number
65. Employment Address
66. City, State, & Zip
68. Service Requirements
70. • The undersigned is hereby contracting for water service with the City of De Soto and understands that persons, firms, or corporations having connection with the City’s water and sewer system shall pay monthly usage and service charges. Sanitation charges are billed monthly on the water bill. All billings are due before the date indicated on each billing to avoid penalties. 
    • The undersigned agrees to claim no damage due to the stoppage of the flow of water resulting from accident or when stoppage is necessary to make alterations, repairs or improvements. The undersigned shall keep all plumbing fixtures on applicant’s premises in good repair, shall promptly stop all leaks from such plumbing fixtures, and shall conserve water in time of water shortage. 
    • The undersigned agrees to abide by the cross-connection ordinance. 
    • The undersigned agrees that if bills or charges remain delinquent on the last day of the month which includes the due date, water service will be terminated. The following provisions will be applied as part of this contract. 
      1. That a 10% penalty will be assessed on any amount that is not paid on or before the date indicated on the bill. 
      2. That service interruption notices will be sent out by regular mail. 
      3. That upon non-payment of the water bill by the interruption date, water service will be disconnected with a $50 reconnect fee.
      4. That water service will be reconnected upon full payment of the water bill and service charges. 

72. All returned checks, which were applied to water accounts will result in disconnection of service if not paid in cash within the allotted time after notification. A $25 returned check charge will also be assessed. Failure to pay final bill in full after 90 days of delinquency will result in customer paying a 20% collection fee.

74. Electronic Signature Agreement

    By checking the "I agree" box below, you agree and acknowledge that 1) your application 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.

    1. I agree.
76. Electronic Signature*
77. Date*
    Date
79. Please upload a copy of your driver's license or picture ID.*
Leave This Blank:


81. 1. Receive an email copy of this form.
82. Email address

    This field is not part of the form submission.

83. Submit

* indicates a required field