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2. Deposits

   Deposit Amounts

   • $100.00 Residential
   • $200.00 Commercial

   Payment of Deposit

   Deposits can be paid in the following ways:

   • In person
   • Dropped in drive thru payment drop box at the City Municipal Building 116 W Needles Ave., Bixby, OK 74008
   • By Phone (A billing Clerk will be in contact with you once the application has been processed.)

   Notice

   Payment of the deposit must be paid in full before service is established.

4. First Name*
5. Last Name*
7. Service Address*
9. City*
10. State*
    -- Select One --AL - Alabama AK - Alaska AZ - ArizonaAR- ArkansasCA - CaliforniaCO - Colorado CT - Connecticut DC - District of ColumbiaDE - Delaware FL - FloridaGA - GeorgiaHI - HawaiiID - IdahoIL - IllinoisIN - IndianaIA- IowaKS - KansasKY - KentuckyLA - LouisianaME - MaineMD - MarylandMA - MassachusettsMI - MichiganMN - MinnesotaMS - MississippiMO - MissouriMT - MontanaNE - NebraskaNV - NevadaNH - New Hampshire NJ - New JerseyNM - New MexicoNY - New YorkNC - North CarolinaND - North DakotaOH - OhioOK - OklahomaOR - OregonPA - PennsylvaniaRI - Rhode IslandSC - South CarolinaSD - South DakotaTN - Tennessee TX - TexasUT - UtahVT - VermontVA - VirginiaWA - Washington WV - West Virginia WI - Wisconsin WY - Wyoming
11. Zip Code
13. Phone Number*
14. Alternative Number
15. Email Address*
17. Do you own or rent the property?*

    1. Own
    2. Rent
18. Type of Service Account*

    1. Residential
    2. Commercial
20. Spouse or Co-Occupant First Name
21. Spouse or Co-Occupant Last Name
23. Would You Like Paperless Billing ? *

    1. Yes
    2. No
24. Date of Service Requested to Be Transferred*
    Date of Service Requested to Be Transferred
26. Have you ever had Bixby Water Service before? *

    1. Yes
    2. No
27. Is this a Transfer of Service?*

    1. Yes
    2. No
29. If so what address? *
31. Upload copy of Photo ID (Front)*
32. Upload copy of Photo ID (Back)*
34. The undersigned, spouse and/or co-occupant(s) agree to pay established rates set forth by the city of bixby ordinances and agrees to regulations governing said services. This application becom es a legal and binding contract upon establishment of service*

    Applicant E-Signature

Leave This Blank:


37. 1. Receive an email copy of this form.
38. Email address

    This field is not part of the form submission.

39. Submit

* indicates a required field