Please enable JavaScript in your browser to complete this form.Name *FirstLastAccount Number *Phone *Email *OWNER IDENTIFICATION * Click or drag files to this area to upload. You can upload up to 2 files. This is a mandatory field. Please upload your passport and one other form of identification.Address of Connections *Address Line 1Address Line 2CityState / Province / RegionApartment / Condo Numbers if necessaryBlock & Parcel NumberType of Premises *ApartmentCondoPrivate HomeType of Premises *ResidentialCommercialNumber of Connections required *PROOF OF OWNERSHIP OF PROPERTY * Click or drag files to this area to upload. You can upload up to 4 files. This is a mandatory field. Please upload up to 4 forms of proof of ownership.PHOTO OF METER CHAMBER LOCATION * Click or drag files to this area to upload. You can upload up to 4 files. This is a mandatory field. Please ensure the location on the photo is marked with spray paint.Signature * Clear Signature I/We the undersigned hereby declare that to the best of our knowledge all the above information is true and correct. I/We understand that any incorrect information may result in disconnection of supply and additional charges. Connection charges are none-refundable. I/We agree to pay all charges related to the connection and supply of water as set out by the company’s charging scheme and abide by regulations of PROVOWATER COMPANY LIMITED. I/We acknowledge that connection or reconnection will not be made until all fees and deposits have been paid.Date SignedDateTimePrint this pageSubmit
