2. Add Name Form

   Please fill out the following form to process your request to add another person to your active utility account.

   Disclaimer: If you submit this form during business hours (Monday through Friday from 8:00 AM to 5:00 PM) it will be completed the same day. If submitted after hours or holidays it will be completed the following business day. Once the form is processed you will receive a confirmation email.

   PDF Version of Form

4. Primary Account Holder Name*
5. Account Number*
7. Service Address*
9. City
10. State
11. Zip Code
13. Phone Number
14. Email Address*
15. Date to have new person added*
    Date to have new person added
17. Name of Person to be Added *
18. Relationship (to Account Holder)*
    -- Select One --Significant Other (Spouse/Fiance/Etc)RelativeFriendRoommatePower of Attorney/Trustee/Legal Representative
20. Email Address of Person to be Added*
21. Phone Number of Person to be Added*
23. Account Responsibility*
    -- Select One --Equally Responsible for Utility Bill/Co-ApplicantMay Inquire but Unable to Make Changes to Account

    Person holds equal responsibility for utility bill if they appear on rental/purchase agreement in any capacity.

25. Two Items of Identification- Residential
    Please provide two forms of identification for the new person being added to the existing utility account
27. Driver's License or Government Issued ID #
28. Date of Birth
    Date of Birth
30. Last Four Digits of Social Security Number
31. Passport Number or A# for I-551
33. Picture ID*

    Attach a copy of the new person's government issued picture ID(s).

35. Additional Document Upload
36. Additional Document Upload
37. Additional Document Upload

39. I hereby request to add a co-applicant at the above location and agree to pay for all electric, water, sewer, fiber, and sanitation services used, delivered or made available at this location until I notify the City in writing to discontinue such services. I agree that all utility services will be delivered subject to the terms and provisions of the Idaho Falls City Code as it now exists or may be generally amended from time to time. I understand the City makes no warranties of any kind and all warranties, whether expressed or implied including all warranties of merchantability and fitness for a particular purpose, are expressly disclaimed. I represent that I am either the owner of the premises described above or am leasing or renting the property from the owner. I also represent that neither I nor any member of my household have a delinquent utility account with the City. I understand that any past debt owed to the City must be paid in full before any City utilities can be connected.

41. Customer Agreement*

    1. I Agree

    By selecting the "I Agree" button, you are signing this agreement electronically. You agree that your electronic signature is the legal equivalent of your handwritten signature and you consent to be legally bound by this agreement's terms and conditions.
43. Account Holder Picture ID *

    Attach a copy of your government issued picture ID

Leave This Blank:


45. 1. Receive an email copy of this form.
46. Email address

    This field is not part of the form submission.

47. Submit

* indicates a required field