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2. IF YOU NEED TO CONFIRM THE CITY OF FLAGLER BEACH PROVIDES UTILITY SERVICES TO YOUR PROPERTY ADDRESS, PLEASE CALL OUR OFFICE AT 386-517-2000 AND PRESS 1

   FOR UPDATED INFORMATION ON COSTS FOR WATER, SEWER, STORMWATER AND SANITATION FEES, PLEASE REFERENCE RECENT RATE SCHEDULE. 

   INFORMATIONAL BROCHURES ON UTILITIES, SANITATION AND

   RECYCLING ARE AVAILABLE AT WWW.CITYOFFLAGLERBEACH.COM

   FOR UPDATED INFORMATION ON COSTS FOR WATER, SEWER, STORMWATER AND SANITATION FEES, PLEASE REFERENCE RECENT RATE SCHEDULE. INFORMATIONAL BROCHURES ON UTILITIES, SANITATION AND RECYCLING ARE AVAILABLE AT WWW.CITYOFFLAGLERBEACH.COM

   AUTOMATIC DRAFT OPTION: Our office offers an auto draft payment option. Your bill will say “Auto-Draft, Do Not Pay” and the amount due will be drafted from your bank account on the due date each month. To enroll, please complete the Automatic Draft Authorization Form online or in person and return to Utility Billing. 

   *MULTIPLE METER DEPOSITS: If the property you are renting/purchasing has multiple meters, you are required per City Ordinance Sec. 5.03.22. to set up accounts for each meter and pay a deposit for each account. 

   FINAL READS: If you are moving in or moving out, a final read work order will need to be placed on the water meter at the property in order to transfer services and to calculate a final bill. Final reads can only be placed on the property by the current owner or owner’s representative (i.e., real estate property manager), current tenant, new owner or new owner’s representative (i.e., real estate property manager) (deed or closing documents must be provided) or new tenant (lease or rental agreement must be provided). If you are moving and are requesting a final read, a forwarding address must be provided when scheduling a Final Read for your Final Bill.

4. SELECT ONE*

   1. Property Owner
   2. Renter
6. Address of New Service*
8. City*
9. State*
11. Zip*
13. Multiple meter deposits for this property?*

    1. Yes
    2. No
14. If Yes, Number of Units
    -- Select One --1234
16. Closing/Lease Start Date*
    Closing/Lease Start Date
20. TAX ID# or SOCIAL SECURITY NUMBER:*

    Please enter Tax ID# for Businesses or SSN for Homeowners

21. DATE OF BIRTH:*
23. MAILING ADDRESS:*
25. City*
26. State*
27. Zip*
29. PRIMARY PHONE #*
30. SECONDARY PHONE #
32. Email Address*
34. Name*
35. Date*
37. Sign Up for Paperless Billing*

    1. YES
    2. NO

    PLEASE NOTE: When signing up for paperless billing, your bills will come from a company called “BS&A.” These emails can sometimes be sent to your junk/spam file. If you do not see your bill, please check there first.

39. Confirmation*

    1. Agree
    2. Disagree

    I (applicant) hereby request the City of Flagler Beach to provide utility services to the above location. I agree to pay all charges for services rendered as a result of this request. I understand and agree that failure to pay any amount due to the City can result in termination of services and legal action for the collection of such sums plus penalties, interest, legal expenses and administration fees. 

41. To expedite processing of these services, please attach the documents below.

43. Copy of Deed or Closing Documents *

    If renting, please attach a PDF of the Executed Lease Agreement in place of the Deed or Closing Documents. 

45. Driver's License Upload*
Leave This Blank:


47. 1. Receive an email copy of this form.
48. Email address

    This field is not part of the form submission.

49. Submit

* indicates a required field