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Utility Account Change Connection/Disconnection

  1. CITY OF BRISTOL, TENNESSEE
    FINANCE DEPARTMENT
    UTILITY ACCOUNT CHANGE
    CONNECTION / DISCONNECTION

  2. CUSTOMER INFORMATION FOR DISCONNECTION (please complete this section only for disconnection)

  3. CUSTOMER INFORMATION FOR CONNECTION (please complete this section only for connection)

  4. PERSONAL INFORMATION NEEDED

  5. A copy of a government issued identification (driver’s license is most often used) must be provided. Current legal name, driver’s license number, date of birth and current contact information must be provided. Please complete the fields above for either connection or disconnection for name(s) on account. A copy of your social security number must be provided. If you prefer, you can call customer service at (423) 989-5500 or submit in a separate email, mailing or fax.

    Any and all service connection fees and deposits will be due upon connection. Any outstanding balances from other accounts will need to be discussed and arrangements made.

    Documentation of purchase and/or closing documentation or a copy of the rental and/or lease documentation will need to be provided. The account can only be setup for services for name(s) matching these documents.

    Please call a customer service representative at 423-989-5500 or email customerservice@bristoltn.org with any questions regarding your disconnection or connection.

  6. All submissions should include a signed agreement. Submissions can be made as follows:
    In person to the Finance Department (Room 203) at City Hall located at 801 Anderson Street.
    Via mail to City of Bristol, Tennessee; Finance Department; PO Box 1348; Bristol, TN 37621-1348.
    Via facsimile to 423-989-5719.
    Via email to customerservice@bristoltn.org.

  7. FOR INTERNAL USE ONLY

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  9. This field is not part of the form submission.