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Extension Request for Utility Payment

  1. Elgin, Texas 78621

  2. I agree to the following Terms of Extension*

    Check all three boxes

  3. I understand that by typing my name above I have agreed to the Terms of Extension and authorize the Utility Billing Department to apply an extension to my account for the current billing period.

  4. If you would prefer to print this form and submit it to the Utility Billing Department, you may use one of the following methods:

  5. City Logo.jpg

  6. Office Use Only

  7. Leave This Blank:

  8. This field is not part of the form submission.