Perkins County Rural Water System, Inc.
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Customer Information Update
Automatic Meter Readers (AMRs)
Customer Information Update Form
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Indicates required field
Name
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First
Last
Name
*
First
Last
Additional Customer
Address
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Line 1
Line 2
City
State
Zip Code
Country
Email
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Email
*
Additional Email
Primary Number
*
Please update your Primary Phone number
Phone Number
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Additional Phone Number
Phone Number
*
Additional Phone Number
Account Number or Tap Number
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Please include at least one tap number or account number to make sure we update the correct information.
Auto-Pay Date
*
Please include the date you would like your automatic payment taken out, 1st to 15th of the month.
Auto-pay information
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Please update your auto-pay information with your routing number and account number or credit card number, expiration date and cvv here
Additional Information or Questions
*
Please let us know if you have any additional comments or questions.
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