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Transfer City Services

  1. Date you will be wanting the new services to start at the new address.

  2. Date you are wanting to stop services at the old address you will be moving from.

  3. Answer YES or NO
  5. Answer Yes or No


    City Hall will contact you via Phone Number on this form to complete application.

  8. This application is an exclusive contract between the City of Clearwater, Sedgwick County, Kansas, and the applicant at the above address. The applicant agrees to be responsible for all payments for water, sewer, and trash services at the above address from the date service under this application is commenced until service is terminated by notice.

    The applicant agrees to abide by the established ordinances, rules and regulations pertaining to services of the City of Clearwater, Kansas, now in force or which may be enacted or adopted and to pay for services at the regular established rates, by 5 p.m. on or before the 14th of each month.

    If the bill is not paid by 5 p.m. on or before the 14th of each month, a 10% penalty charge will be assessed on the net water/sewer/trash bill and a shut off notice will be sent on the 15th of the month.

  9. Connection Fee

    The connection fee is a one time charge and will be added to your first bill. If you are a new customer to Clearwater the fee will be $50.00. If you already have utility services in your name and are moving to a new home your fee will be $15.00.

  10. Leave This Blank:

  11. This field is not part of the form submission.