Forms & Contracts

Are you wanting to become a member or make changes to an existing membership account? The below forms will be able to help.

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The E J Water Cooperative, Inc. web site offers most of the same contracts and forms available at our office. The forms (see right column) can be downloaded and printed. If you do not see the document you need, you may contact the E J Water Cooperative, Inc. office.

EJ Water Cooperative Forms and Contracts

Residential User’s Contract ($2,000.00)

This contract is for customers whom are along an existing water main and wanting to tap on. The customer must own the property all the way up to the road which our line runs along.

Residential User’s Contract ($1,000.00)

This contract is for customers who are not along a water main and are wanting water. Customers signing up before a Phase comes through or after a Phase has come through and the lines did not go past them will use this contract.

Direct Pay Agreement

This contract will set up an automatic withdrawal from your checking or savings account.

Renter’s Agreement

Our renters contract is to be filled out by the renter of the property and requires the renter to pay a $100 deposit, which will be refunded to them when they move out as long as all bills are current, plus a $25 transfer fee to get the bill into their name.

Rent Exemption Contract

This contract can be signed by owner’s of a rental property if they wish to waive the $100 deposit for their renter, assuming full liability for prompt payment on the account, having the renter pay only the $25 transfer fee.

Last Name Change

This form is for someone recently married/divorced whom would wish to change the last name on their account.

Cancellation Form

If you are electing to voluntarily cancel your user’s contract fill this form out and send it in to our office.

Crop Damage Claim

Crop damage is based on actual yield per acre after harvesting remainder of field. Fill out the following form and send it into our office with your yield and we will acquire the measurements from our engineers office to pay for the appropriate crop damage.

Air Evac Contract

EJ Water has partnered with Air Evac Lifeteam to offer you as an E J Water Cooperative member the opportunity to join Air Evac Lifeteam’s Membership PRogram at a special “customer’s-only” discounted rate! Please fill out the attached contract and mail your enrollment form to AirMedCare Network, PO Box 948, West Plains, MO 65775.

Heartville Public Water District Contracts

Application for Water Service

To obtain water service with Heartville Public Water District please fill out the following form and return it to the office.