Please enable JavaScript in your browser to complete this form.
This is to update information for existing account holders. For new owners/tenants, please
submit an application to start service
.
**Please be advised, you must be the account holder to update any info on the water account**
Select Type of Account
*
Residential Owner
Residential Tenant
Commercial Owner
Commercial Tenant
Account Number
*
Name
*
First
Last
Drivers License Number
*
Last 4 digits of Social Security Number
*
Service Address
*
Address Line 1
Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Phone
*
Email
*
This request is to
*
Change the mailing address
Provide updated authorized agent information
Add or update the primary telephone number
Add or update the primary email address
(Please select all that apply)
New Mailing Address
Address Line 1
Address Line 2
City
State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Authorized Agent
First
Last
Authorized Agent Telephone
Authorized Agent Email Address
Primary Telephone Number
Primary Telephone Type
Cell Phone
Home
Work
Primary Email Address
By typing or signing my name below, I verify that I am authorized to make updates to this City of Antioch Water Account.
*
CITY OF ANTIOCH
FINANCE DEPARTMENT
PO BOX 5007
ANTIOCH, CA 94531
(925) 779-7060
(925) 779-7054 fax
service@antiochca.gov
Enter an Email Address if you would like to receive a copy of this form
Email Address
Website
Submit