2. First Name*
3. Last Name
5. Street Number*
6. Street Name
8. City
9. State
10. Zip
12. Account Number*
13. Phone Number
15. Email Address *
17. Note
    The City of Garden Ridge promotes environmental sustainability practices and encourages the e-bill option. You must keep your e-mail address current and contact the City directly if you do not receive your paperless bill notice. You agree to hold the City harmless for any delay or failure to deliver or receive the paperless bill notice. You are responsible to submit on-time payments as due dates will remain the same.
19. E-Bill Approval *

    1. Yes

    I authorize the City of garden Ridge to send my utility bill electronically via e-mail.
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21. 1. Receive an email copy of this form.
22. Email address

    This field is not part of the form submission.

23. Submit

* indicates a required field