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2. Name*
4. Account Number*
   999xxxxxx
5. Customer ID (6 digits)
7. Service Address*
9. City*
10. State*
11. Zip Code*
13. E-Mail Address*
14. Confirm E-Mail Address*
16. Home Phone # *
    (enter N/A if applicable)
17. Cell Phone #*
19. The following Terms and Conditions apply:
21. > Electronic delivery of Frederick County's water/sewer bill is optional. You are requesting that your water/sewer bill be delivered to the e-mail address listed above.
23. > No paper copy of the bill or late notice will be mailed.
25. > It is the sole responsibility of the customer to maintain a valid e-mail address and to keep it current with the Frederick County Division of Water and Sewer Utilities. Failure to receive/review/act on any e-mail does not relieve the property owner from the obligation of payment of the bill and/or all fees charged related to late payments, service interruption or tax sale proceedings. It is the customer's responsibility to notify the Division of Water and Sewer Utilities of any updates.
27. Please check below to confirm:*

    1. I accept the Terms and Conditions as stated above.
29. When completed, click on the Submit button below. Once we have received your request, confirming your acceptance, we will update your account and your next bill should arrive by e-mail. If you have any questions, please contact the billing department at 301-600-2354.
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31. 1. Receive an email copy of this form.
32. Email address

    This field is not part of the form submission.

33. Submit

* indicates a required field