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Page last updated on April 13, 2026 at 3:45 pm

Online Forms for Service

The City of Bloomington Utilities offers online forms for making adjustments to service. To ensure next-day service, forms must be submitted by 5:00 pm Monday through Friday, excluding City holidays. If you do not see what you are looking for, please call the Utilities Department at 812-349-3930.

Residential Service

Sign up for Residential Service 

Commercial and Multi-Family Service

Commercial Customer Contract 

Automatic Payments

Sign up for Automatic Withdrawal 

Disconnect Service

Disconnect Utilities Service 

Special Read Agreement (for landlords)

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

Special Read Agreement 

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 

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.

Sign up for Service

Sign up for Residential Service (PDF)

Sign up for Commercial Service (PDF)

Automatic Payments

Sign up for Automatic Withdrawal (PDF)

Cancel Automatic Withdrawal (PDF)

Disconnect Service

Discontinue Utilities Services (PDF)

Special Read Agreement (for landlords)

Special Read Agreement (PDF)

Special Read Agreement Cancellation (PDF)

Name Change

Name Change Form (PDF)

Request an Adjustment due to Leak

Request for Adjustment Due to Leak (PDF)

Lab Test and Report

Water Test Report Form (PDF)

Pool Test Report Form (PDF)