ACCOUNT CHANGE / UPDATE

ACCOUNT CHANGES ARE NOT AUTOMATICALLY GRANTED UPON REQUEST.

* * * SIGNATURE* By typing your name in the signature box above, you are signing this document electronically. You agree that your electronic signature is the legal equivalent of your manual signature on this request form and you acknowledge and accept the rules and regulations set forth within the TLWCI -Tariff Schedule. This document is available for review under the INFORMATION section of the www.TLWCI.com website.

YOU MAY BE CONTACTED IF FURTHER INFORMATION IS REQUIRED AND WILL BE NOTIFIED WHEN CHANGES HAVE BEEN APPROVED.

TWIN LAKES WATER CO., INC.

ACCOUNT CHANGE / UPDATE

PLEASE COMPLETE THE FORM BELOW TO REQUEST CHANGE / UPDATE TO YOUR EXISTING ACCOUNT OR TO ESTABLISH A NEW ACCOUNT.

ACCOUNT CHANGES ARE NOT AUTOMATICALLY GRANTED UPON REQUEST.