Palmdale Water District - Online Account Access


	The Palmdale Water District in an effort to better serve our customers has setup online account access. In order to use this service you will need your most current billing statement to establish access. Please fill out the following form to sign-up for the Palmdale Water District online account access. All fields on this form are required with the exception of work and cellular telephone. If you do not have a home telephone then input a cellular telephone number. The telephone numbers we are requesting are to update our records in case we need to contact you for any reason related to your water service such as emergency shutoff, service outage, etc. After submission a confirming eMail will be sent to the eMail address provided with a temporary login password that you will be requested to change. Because of this we ask if you are using a spam blocker or spam blocking service please include the domain name @palmdalewater.org to the allow access or friends list or you will not receive this initial email.
	Customer ID:

	Customer Name:

	Service Address:

	Statement Number:

	Enter your customer name, service address and statement number EXACTLY as it appears on your billing statement.



	Home Telephone:

	Cellular Telephone:

	Work Telephone:		Ext.

	Enter telephone numbers in the following format without spaces and include area code 6619474111.



	Enter eMail Address:

	Confirm eMail Address:

	I agree to these Terms and Conditions