Budget Payment Plan Program Enrollment Form

The enrollment period for customers with Gas Service Only is June 1st through August 31st.   The annual settlement month for this Budget Payment Plan is May.

Customers with electricity only or any combination of utility types (ex. Electric, Gas, Water, Sewer, Solid Waste, Irrigation) can sign up November 1st through through January 31st.  The annual settlement month for this Budget Payment Plan is October.

Note: If full payment is not posted on or before the due date, you will be removed from the Budget Payment Program.  A late or missed payment is subject to normal City of Mesa credit procedures.  See the Service Policy for Utility Customers for more information.

  

                 Customer Infomation
  *Last Name
  *First Name
  Middle Initial
  *Utility Account Number (12 digits)
  *Last 4 Social Security Number
*Date of Birth
  *eMail Address
  *Residential Phone Number
     
                   Service Address    
  *Street Address
  Unit Number
  *City
  *State
*Zip Code
How did you hear about the Budget Pay Plan program?
        Bill insert Electronic Newsletter
         Customer Service representative City of Mesa web site
        Mailing to your home Other web site
         Friend/relative Newspaper
       

 Questions or comments: