Request For Water and/or Sewer Service

Application for New Customer Service - The Borough of Hollidaysburg

This document is an application form used by residents or businesses to request new water and/or sewer service from the Borough of Hollidaysburg, PA.

Key Information Required:

• Applicant Billing Address: Name, phone number, street address, city, state, ZIP code
• Ownership Status: Indicate if you are the owner, owner’s agent, or tenant
• Owner's Name: If different from applicant
• Service Street Address: Where the service will be provided
• Date Selection: Choose one of: Closing Date, Move-In Date, or Lease Signed Date

Fees and Payment:

• A $20.00 transfer fee must be paid before any change in service can occur.
• Payment options include:
  • Cash
  • Check (with check number)

Services Requested:

Check off which services are needed:

• Water Service
• Sewer Service

Certification Statement:

The applicant certifies that all information provided is accurate and authorized by the property owner. They also agree to comply with local regulations governing water and sewer services as outlined in the Hollidaysburg Borough Authority rules and relevant ordinances.

Signature Section:

• Applicant’s signature required
• Date of signing

---

This form ensures proper setup and billing for utility services while confirming legal authorization and compliance with local regulations.