Contact Information Form

Lakehurst Water & Sanitation District is in the process of updating our customer database. We will be notifying customers of impending suspension of their water service due to delinquency. If you wish to take advantage of this service, or make changes to your current account, please complete the information below. (Limited to two phone numbers and one email address.)

Name:

Account Number:

Address:

City

State

Zip

Home Phone:

Cell Phone:

Email:

Click here if you wish to print this form prior to submitting.