GMSA - RESIDENTIAL UTILITY ON-LINE APPLICATION

 

GMSA OFFICE EMAIL: gmsaoffice@cityofgroveok.gov

GMSA PHONE NUMBER: 918-786-5171 OR 918-786-5353

 

The City of Grove is unable to process on-line payments for deposits at this time.  Call 918-786-5171 to pay your deposits over the phone with a debit or credit card after you successfully submit your online application.  You may also bring by or mail your deposit to GMSA, 1201 NEO Loop, Grove, OK 74344.

SERVICE START DATE
SERVICES REQUIRED (MARK ALL THAT APPLY) *
UTILITY APPLICATION FOR: *
APPLICANT IS *
IS THIS PROPERTY A RENTAL? *
MUST include First & Last Name (Must be completed if property listed as rental)
Including Area Code
HAVE YOU EVER HAD SERVICE WITH GMSA *
This should include Building, Apartment, Suite or Lot Number (if applicable)
MUST include First and Last Name as it appears on photo ID
Files must be less than 2 MB.
Allowed file types: gif jpg jpeg png pdf.
Including Area Code
Including Area Code (AT LEAST ONE PHONE NUMBER MUST BE INCLUDED)
If Retired or Unemployed please type "Unemployed" or "Retired"
Including Area Code
MUST include First and Last Name as appears on photo ID
Files must be less than 2 MB.
Allowed file types: gif jpg jpeg png pdf.
Including Area Code
This should include Building, Apartment, Suite, or Lot Number (if applicable)
MUST include First and Last Name (Someone not listed as an applicant)
Including Area Code
SECURITY DEPOSITS *
A security deposit is required for all accounts at the rates set and established by ordinance. Security deposits are refunded only when service is terminated.
REASONABLE ACCESS *
The Applicant/Co-Applicant shall permit GMSA authorized representatives to enter onto the customer's premises at all reasonable times for purposes connected with repairing, replacing, rendering, billing, or disconnecting utility services. Services may be terminated if reasonable access is not permitted.
STATEMENT DATES *
Statements are sent out on the 1st, 10th and 20th of each month, depending on which billing cycle you are in. Payments are due the 15th, 25th and 5th of the month, respectively. The failure of any customer to receive a statement for any utility charges shall not excuse the customer from their obligation to pay such charges within the time specified.
EQUIPMENT *
Water and gas meters, as well as any automated meter reading devices, are the property of GMSA. It is unlawful for anyone to break, damage, tamper with, or obstruct the flow of or prevent the proper running of the equipment in any manner whatsoever. Customers who may commit any of the offenses listed above will be charged a fee for water or gas lost and a fee for any damages to any GMSA equipment and may have criminal charges filed against them.
CELL PHONES *
If, at any time, I provide a wireless telephone number where I may be contacted, I consent to receive calls (including auto-dialed calls and prerecorded messages) at that wireless number from Grove Municipal Services Authority, its successors and assignee's, and the affiliates, agents and independent contractors, including servicers and collection agents, of each of them regarding the services rendered, or my related financial obligations.
DRIVERS LICENSE *
I agree to provide a copy of Drivers License of Applicant & Co-Applicant to GMSA.
Include First and Last Name
DATE OF SIGNATURE
AGREEMENT BOX *
MUST include First and Last Name
DATE OF CO-APPLICANT SIGNATURE
CO-APPLICANT AGREEMENT BOX
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