City of Bloomington Utilities
Request for Individual Name Change
Name change
request form. You will need a substantiating document (marriage license, divorce decree, etc.) to attach as a file to this form.
Customer Service Office Contact Information
Operating Hours
8:00 am to 5:00 pm M-F
Address
600 E Miller Dr
Bloomington IN 47401
Phone Number
(812) 349-3930
Email Address
utilities.cs@bloomington.in.gov
*
Field is Required
First Name
Middle Name
Last Name
Former Last Name
Telephone Number
Email Address
(Please provide an email address to receive a confirmation email and status updates)
The service address is:
Lookup Address
St Num
St Dir.
Street Name/Unit
City of Bloomington Utilities Account Number
Please include either a photcopy of your driver's license, a marriage license, or a divorce decree. If you send a driver's license, please make sure it shows the new name change.