Town of Bargersville

Utility Forms

Following are links to various utility forms.  These forms are in .PDF file formats, therefore you will need the most recent version of Adobe Acrobat Reader to download and/or fill in and E-mail them.  Adobe Acrobat Reader can be downloaded for free at www.Adobe.com.  

• Authorization to Disclose Account Information form
• Automatic Payment Plan (ACH) form
• Builder Agreement form
• Builder Permit Application
• Commercial Service Application
• Electric Trenching Notice form
• Final Account form
• Mortgage / Realty Company Application form
• Name Change Request form
• Outdoor Security Lighting Application form
• Payment Agreement form
• Personal Sewer Agreement form
• Rental Property Owner Agreement form
• Residential Service Application
• Storm Water Complaint form
• Tree Trim or Removal Consent form

To know more about your rights and responsibilities as a Bargersville Utilities customer, please click on the following link:

• Rights and Responsibilities pamphlet

Any questions or problems with these forms please let us know.