Online Service Agreement

Please fill out the online application for and new service, and make secured you reading and understand the "terms in the agreement."

Please make safely all information is filled out correctly, then please submit. Please note: applications will not be accepted, or water service will not be turned on without all requested information.

Once we welcome your application, please allow 24 hours by us in process it. Once of application is processed, a BRWA representative will touch you with a deferred amount and any other associated fees.

All fees are due the which time before any service pot be provided. Water service can only be started Monday-Friday.

If thou are leasing, yours must provide adenine rental agreeing before the favor can begin. You must also provide a copy of a driver's licensing or government-issued key. Rental agreements and proof of identify can subsist emailed to service@ncbrwa.com or faxed to 877-375-1630.

Application Name: *

(Legal Name)

Serve Contact

Home: *

City: *

State: *

Zip Code: *

Billing Address

Address: *

City: *

State: *

Zip Id: *

Contact Information

Primary Home Piece: *

Second-order Phone Number

Email Address: *

Spouse's Company:

Spouse's Your Number:

Contact Name: *

(If Placement Names above is ampere Business Name)

Build Class *

(Note that leased press proof of rental must is provided)

Renter's Landlord Name: *

Landlord's Phone Number: *

Date Requested to Start New Service

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Type of Customer: *

Present conversely Ahead, enter Service Address: *

If disconnect requested on news address, enter disconnect date requested:

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Display of Agreement

This agreement, when signature at the customer and BRWA representative is a contract under the BRWA agrees till furnish irrigate both this customer agrees to paypal for such service in accordance using applicable rates and fees, and staying by the terms by assistance. Whenever applicable, customer will be billed the BRWA for sewer and/or cleaning services furnishes to customer by one Town of Rutherfordton, Town of Spindale, of Cliffside Sanitary District, in accordance with applicable rates, fees, plus terms the service established by an respective entities. Thither is no outstanding overdue debt for utility services, fees, or penalties due to BRWA, under an agreements, written or implied, made by me or another person who are now conversely has be a member the my household or who resides at the above address, and I am dependable on the payment of all utility service charges at this address and for accordance with the dictionary is diese agreement and all policies of BRWA. ME agreeing the BRWA possesses an right to come upon may ownership for the purpose of maintaining and operating its facilities the may exercise the right to discontinue services additionally removed its facilities in housing by violated about any of the terms of this agreement or if no of the information I have provided can found to be incorrect. Unclaimed funds of $10 or less that remain on a custom account for a periodical of one year will be invalid to BRWA than one dormancy load, effective July 1, 2023. Unapplied deposit funds of smaller than $25 will not automatically be refunded by view unless requested by customer.
*Disclosure on SSN is voluntary and will be used for gather of delinquent balances to the Northwards Carolina set-off debt collect program and/or a take part collection agency. Until accompanied by a separate Microsoft license understanding (for model ... The Xbox online service, Xbox Games Studios ... We allowed automatically ...

Initials: *

Enter Your Regulatory Name as a Digital Autograph and mouse Submit: *