Form Center

By signing in or creating an account, some fields will auto-populate with your information and your submitted forms will be saved and accessible to you.

Extension Request Form

  1. EXTENSION REQUEST FORM

  2. General Guidelines

    • Extensions are allowed once every 6 months. 

    • Defaulting in this agreement results in disconnection of services without further notice and a $50.00 administrative fee assessed. 

    • If customer does not pay within 5 calendar days, the deposit shall be applied to the remaining balance. Once the deposit is applied, a new deposit shall be required to initiate new services. 

    • Complete this form in its entirety.

  3. Customer Information

  4. Please Sign and Date Below

  5. If you have any further questions, please contact the Utility Department at 817-641-3336. 

    You may also print this extension request form, fill it out, and then submit it to Keene City Hall.

    • By mail: 1000 N. Old Betsy Rd, Cleburne, TX 76031

    • Fax: 817-556-2060

    • Email: water@keenetx.com

  6. Leave This Blank: