Start Service - Nebraska City Utilities

save to a file or print and email or return to: service@ncunebcity.com

NCU Service Application Fillable Form

Start Service and Payment Plan

"*" indicates required fields

Use this form to request a service application for new service and service changes, or payment plan application. Please complete all areas of this form. Incomplete forms will delay the process time. Directions: Use the tab key or your mouse to move through the fields. All information given to Nebraska City Utilities will be confidential and used only to mail appropriate request.

Name*

Date for Service Start Up*

HOME OWNER ?

YES

RENTER ?

YES

Service Address*

Street Address City State ZIP Code

Phone Number*

Email*

Select Application Request

Service Application

Level Payment Plan

Automatic Bank Payment (EFT)

Upload Photo ID

Max. file size: 50 MB.

Photo ID is required when selecting Service Application. This is required for security and safety of our customers to verify that service is being set up under correct identification. Services will not be implemented without appropriate identification. Please scan or take a photo of your ID and upload the image here.