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2. ONLINE E-BILL ENROLLMENT FOR PAPERLESS UTILITY BILLING
4. 
6. The Village of Channahon is excited to offer a paperless billing option to its residents for utility services. To avoid receiving a paper bill delivered via postal mail, you can now sign up to receive your Village of Channahon utility bill via‐email. Complete the enrollment form below to sign up for E-Bill. E-Bill allows you to be environmentally friendly and eliminates the delay of sending the paper bill through the mail. The E-Bill will be created and emailed to the email address you have designated below. The E-Bill will look identical to the paper bill you would normally receive in the mail.
8. To enroll in the Village of Channahon’s E-Bill, please complete the form below. You should expect an email from the Village of Channahon in the next billing cycle once the completed form is received by the Village and your account information has been updated to receive an E-Bill.
10. Be sure to add utilitybilling@channahon.org to your safe senders list in your email client, or check your spam folder for messages.
12. Water/Sewer Account#
    Enter your billing account number
13. Phone #*
    Enter your telephone number, including area code
15. Name on Account*
    Enter the name of the person registered on the account
17. Please Check One*

    1. Owner

    1. Tenant

    Please select whether you are the property owner or a tenant/lessee of the property
19. Service Address*
    Enter the address that receives water, sewer, and/or garbage service from the Village of Channahon
21. Email Address for Billing*
    Enter the email address where you would like your e-bill to be sent
23. Second Email Address for Billing
    If you would like someone else to receive a copy of your e-bill, enter their email address here
25. Electronic Signature Agreement*

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
27. Electronic Signature*
    Signature of applicant
28. Date*
    Date
    Today's date
Leave This Blank:


30. 1. Receive an email copy of this form.
31. Email address

    This field is not part of the form submission.

32. Submit

* indicates a required field