Customer Service:  334-720-0731

Report Outage:  334-720-0700

UBT
UBT

1. Personal Information

1/5  Personal Information

2. Service Information

2/5  Service Information

3. Credit Check Authorization

3/5  Credit Check Authorization

4. Agree & Sign

4/5  Agree & Sign

5. Review and Acknowledge

5/5  Review and Acknowledge

Upload Photo Identification

Important: We can't accept password protected files. Supported file formats are jpeg and png. The total file size limit can't exceed 3 MB.

Personal Information

Please provide your personal information below.

Asterisks (*) indicate fields required to complete this form.

Photo Identification

Are you a Student?*

Next of Kin Information

Employer Information

Service Information

Upload Photo Identification

Important: We can't accept password protected files. Supported file formats are jpeg and png. The total file size limit can't exceed 3 MB.

Service Information

Please provide your service information below

Asterisks (*) indicate fields required to complete this form.

Previous or existing UBT service

Have you or your spouse previously had services with UBT?

New UBT Service

Please provide the address to the property for service.

Mailing Address

Please provide the mailing address where you'd like to receive mails from us.

Renter Information

Do you, the applicant own the property where service is requested?

Last Address

Credit Authorization

Credit Report
Authorization and Release

Please complete the below information

Asterisks (*) indicate fields required to complete this form.

Agree and Sign