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E-billing

Date*
Date
Account #
First Name
Last Name
Address
City
State
Zip Code
Email Address
Phone Number
123-123-1234
Disclaimer*
1. Accepted
The City of Elkhart utility bill is the 10th of each month. Please remember the bill is due each month regardless of whether an email was received.
To stop E-billing
If at any point you wish to stop receiving paperless bills contact the utility department at utilitybill@elkhart.com or 620-697-2554
Electronic Signature Agreement
By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.
1. I agree.
Electronic Signature

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E-billing