2. Name Change Form

   Name Change Form Please fill out the following form to process your Name Change request to your active utility account. Disclaimer: If you submit this form during business hours(Monday thru 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 Name*
5. Account Number*
7. Service Address *
8. Date of Name Change (Monday thru Friday)*
10. Original Name *
11. New Name*
13. Phone Number
14. Email Address
16. Two Items of Identification
    Please provide two forms of Identification for the name change.
18. Driver's license or government issued ID #
19. Date of Birth
21. Last four digits of social security number
22. passport number or A# for I-555
24. Picture ID *
    Attach a copy of your government issued picture ID(s).
26. I hereby request to do a name change 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 changes can be made to an active utility account.
28. 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.
Leave This Blank:


30. 1. Receive an email copy of this form.
31. Email address

    This field is not part of the form submission.

32. Submit

* indicates a required field