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Application for Transferring Residential Utility Services

  1. PublicWorks
  2. City of Waynesboro Application For Transferring Utility Services
    ****This form is for Residents of Waynesboro who are moving within the city**** Residents requiring water, sewer, and trash services must complete this Service Application. The deposit for residential tenants shall be billed at a rate of $75.00 over the first 2 billing cycles for a total of $150.00. This deposit will transfer if tenant is moving into another residential tenantship. Please contact the City of Waynesboro Utilities Office at 942-6643, Option 4, if you have any questions
  3. Are You:*
  4. If you are RENTING please attach a complete copy of your RENTAL AGREEMENT/LEASE. If you have BOUGHT a property, please attach a copy of a PURCHASE AGREEMENT
  5. Current Service Address in Waynesboro
  6. New Service Address in Waynesboro
  7. Mailing Address (If Different than New Service Address)
  8. Garbage Service?*
  9. Primary Applicant
  10. Secondary Applicant
    (This person is also responsible for the bill, and can make changes to the account. )
  11. (City may contact and/or contact City on your behalf. This individual is not responsible for the bill, but city staff can discuss account information with them)
  12. Leave This Blank:

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