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2. 

                       7985 FM 2932, Aubrey, TX 76227

4. Spiritas Ranch
6. Phase
7. Tract
9. Company Name
11. Builder Phone Number
13. Builder Email Address
15. Accounts Payable Phone Number
17. Accounts Payable Email Address
19. Service Address
21. City
22. State
23. Zip Code
25. Lot
26. Block
28. Billing Address
30. City
31. State
32. Zip Code
34. Type of Service*
    -- Select One --Builder (Water & Sewer)Builder (Water, Sewer, & Irrigation)Irrigation (Water Only)
36. Electronic Signature Agreement

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
38. Electronic Signature*
40. Date*
    Date
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42. 1. Receive an email copy of this form.
43. Email address

    This field is not part of the form submission.

44. Submit

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