Update Your Account

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Please correct the field(s) marked in red below:

Instructions: Please complete and submit the following form. If you prefer to print out and complete the form off-line, please print clearly and complete all sections of the form that apply to you. Submit completed application and documentation via e-mail here: WaterServiceRequest@mlbfl.org, or mail to Utility Service Request, 900 E. Strawbridge Avenue, Melbourne, FL 32901.

Required Documents: Attach all required documentation before submitting your application.
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Select one of the following and complete the sections indicated:
Select one of the following and complete the sections indicated:

If you checked the "Automatic Bank Draft Payment Option", please complete the following:

READ AND INITIAL: "I have given authority to the City of Melbourne, providing services to the account(s) listed, to draw drafts against my bank account for payment of my utility bills. I authorize such drafts to be drawn and presented for payment until authority is revoked. I understand that payments will be drafted on the due date of my bill. Should I close my utility account I understand that my final bill will not be drafted. I also understand that if I change banking institutions, it is my responsibility to provide new account information to the City of Melbourne. Failure to do so, may result in missed payments and/or return fees."


Applicant Information
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Applicant Information

Please be advised that all information provided in this application becomes a matter of Public Record, and the City is required to make the information available upon request, with the exception of information designated by law as "exempt" or "confidential".
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Please be advised that all information provided in this application becomes a matter of Public Record, and the City is required to make the information available upon request, with the exception of information designated by law as "exempt" or "confidential".
By submitting this form electronically you are providing an electronic signature and confirm that you have read and understand the above disclosures.
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