Water Renter Application

Business Office/Water Department

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Macomb, Illinois

INSTRUCTIONS: Water service can only be setup in person, online, or by mail. You may not set up service over the phone.

MAIL FORM AND A CHECK FOR $100.00 AS A DEPOSIT payable to Macomb City Waterworks to:

Macomb City Waterworks
PO Box 377
Macomb, IL 61455

You may use a credit/debit card by selecting Payments from the menu bar above. Please, select Water Deposits: Pay Location Code 2237 . A nominal fee is charged for their services.

You may also go directly to Allpaid.com and use Pay Location Code: 2237. Water Deposits Click Here: Pay Location Code 2237

Water Department hours:

Monday-Friday, 8 AM – 5 PM
Closed Holidays
Customers request for service must be made before 2:30 PM to guarantee same day service

Services will not be turned on until the renter form and deposit have been received by the Water Department, and then an appointment must be made to have the service turned on. Someone must be present at time of turn on.

Please contact the Water Department Business Office at 309-833-2031 to insure that all requirements have been met, and to make an appointment.

**PLEASE REMEMBER, FORMS AND DEPOSITS MUST BE RECEIVED THE SAME DAY

FORMS RECEIVED WITHOUT DEPOSIT WILL BE NOT BE PROCESSED!**

"*" indicates required fields

Applicants Name*

First Last

Phone*

Social Security Number*

Upload Driver's License*

Max. file size: 50 MB.

In Case of Emergency Contact*

First Last

Phone*

I would like to be paperless

yes

If yes, enter email

I would like to set up for auto bank payments. If yes fill out infomation below.

yes

Name of Banking Instution

Address of Bank

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

What type of account is this?

Checking

Savings

Routing Number

Checking Number

Service Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Previous Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Only fill in if previous address was in Macomb, if not then leave blank.

Mailing Address (if different than Service Address)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Secondary Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

This should be a good forwarding (safe) address for purposes of mailing a refund check, should there be one.

Landlord's Name or Company Name*

Landlord's Phone Number*

Landlord's Address

Street Address Address Line 2 City State ZIP Code

I request the water to be put in my name at the above address on (date) and understand that I am responsible for the bill until I notify the Macomb business office of my termination of service at address listed above*

*Please call the business office to confirm if an appointment time is necessary for turning on water

Today's Date*

Renter's Signature

A $100 deposit is required of all renters.

Checks can be made payable to the City of Macomb

City of Macomb Business Office 309-833-2031 | Po Box 377 Macomb IL 61455 | Waterclk@cityofmacomb

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Business Office/Water Department

Macomb, Illinois