Form Center

By signing in or creating an account, some fields will auto-populate with your information and your submitted forms will be saved and accessible to you.
The following form may request personally identifiable or protected health information. Please see our Privacy Policy for details. This form is encrypted. SSL is on to ensure a higher level of security. A recaptcha must be completed before submission, you cannot save progress, and you cannot receive an email copy of the form.

Payment Arrangement Form

  2. Arrangement Request

    Payment Arrangements may only be requested by the account holder, are treated as payment extensions, and can only be granted once every (3) three months. Water service is disconnected once the account becomes 10 days past due.  An arrangement will defer the amount owed by an additional seven (7) days. There is a $10 administrative fee for each Arrangement. Requests must be received and accepted by 5:00pm one (1) business day prior to the scheduled cut-off date. Arrangements are not considered finalized without an email confirmation of acceptance from the Utility Billing Department. Accounts with less than 3 months of credit history are not eligible for an extension. If you have any questions about the status of a request, please call 972-552-7304 M-F 8AM-5PM.

  6. Utility Account Number

  7. Please provide the ID/DL number on your account to verify your identity.

  13. Utility Service Address

  16. A confirmation will be emailed to this address to confirm if the payment extension is accepted. Please call if you do not receive an email confirmation.

  17. If your account has less than 3 bills paid you will not qualify for a payment arrangement.

  19. If you have had a payment arrangement within the past 3 months you will not qualify for an additional arrangement.

  22. I agree to the Arrangement terms identified here. I understand that standard late fees will be charged per ordinance on any outstanding balance, and I acknowledge that if the payment terms are not met as stated above, my account will be charged an additional $50 Administration Fee and my service will be disconnected. I understand service will NOT be reinstated until payment is received in full. I acknowledge that arrangement extensions can ONLY be requested once every three (3) months and will not be allowed if the account has failed an arrangement within the prior 12 months or has already had an arrangement extension within the a three (3) month period. The City of Forney has the right to refuse arrangement extensions for any reason. I agree to receive communications from the City of Forney with the contact information provided.

    23. Leave This Blank: