Tenant Application for Water Service

In the event that you do not move into the property or the date is changed, please notify Aquarion immediately in order to avoid billing errors.

Note: If you prefer to download and fax the form back to us rather than complete it online, please use fax number 203-445-7308. For clarity purposes, please type the downloaded form rather than handwrite it.

If you have any questions or difficulty completing the form, please contact us at 203-445-7310 or 1-800-732-9678.


Date Service is Requested

Must be within last 90 days

Period of Lease (minimum 6 months)

Service Information


Billing Information

A valid phone number must be entered. We do not sell or utilitize your number for anything other than official Aquarion business, such as a “Code Red” in the event of water outages or other emergencies. If you would prefer to not receive these calls, please call our call center or email us at CS@aquarionwater.com.

(We will never disclose your email address)


Landlord Information

A valid phone number must be entered. We do not sell or utilitize your number for anything other than official Aquarion business, such as a “Code Red” in the event of water outages or other emergencies. If you would prefer to not receive these calls, please call our call center or email us at CS@aquarionwater.com.

We will never disclose your email address.


Have you ever had service with us before?
Address 1
Address 1
Address 2

IMPORTANT - this box must be checked

By checking this box and submitting this form, I agree that I am responsible for the water utility bill from the date service is requested and that I understand that a security deposit will be applied on my first bill (see fees below). When an account with a deposit has
maintained an excellent credit rating (no late notices or fees) for one year, the deposit plus interest will be credited to the account at that time; or upon final termination of the account with Aquarion.

Security Deposit Fees

Commercial Tenant Deposits - Commercial tenants must pay an initial deposit of $100
which will be reviewed for adequacy after the first bill. If the average billings over 90 days
exceed $100, you may receive a request for an additional deposit.

Residential Single-Family Tenant Deposits - Residential tenants must provide a
security deposit of $100.

  
Note: All fields are required unless specified