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City of Bloomington, Indiana

Online Forms for Service

City of Bloomington Utilities offers online forms for making adjustments to service. If you do not see what you are looking for please call the Utilities Department at (812) 349-3930.

Residential Service

Individual Customer Contract

Commercial and Multi-Family Service

Commercial Customer Contract

Automatic Payments

CBU Authorization Agreement for Preauthorized Payments (Aqua Pay)

Disconnect Service

Request for Disconnect of Service and Final Bill

Special Read Agreement

When renters leave a property, property owners can sign up to have service automatically transfer back to them with a Special Read Agreement

Rental Information Packet for CBU Customers

Special Read Agreement
Special Read Agreement Cancellation

PDF Forms for Service

PDF versions of forms are printable alternatives of the online forms. These can be submitted in person, faxed, or scanned and emailed.

Residential Service

Sign Up for Residential Service

Application for New Water/Sewer Connection Residential

Application for Extension of Utilities Service

Request for Adjustment

Commercial and Multi-Family Service

Sign up for Commercial Service

Application for New Water/Sewer Connection Commercial

Application for Extension of Utilities Service

Request for Adjustment

Automatic Payments

Sign up for Automatic Withdrawal

Disconnect Service

Discontinue Utilities Service

Special Read Agreement

Special Read Agreement 2014
Special Read Cancellation (for landlords)

Name Change

Update the name on your account after a legal name change (e.g. marriage). Do not use this form to put service in someone else's name. Use the Residential Service contract to assign a new person to the account.

Name Change Form

Lab Test and Report

Lab Test Report Form