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2. 
4. This form is to be used by new Homeowners of the Village of Richton Park. Please fill out form completely and print a copy and bring to the Village Hall with the following documents: Settlement Statement, Copy of Photo ID, Certificate of Occupancy Inspection, and $50 Water-Application Fee.

   Please Note: An appointment will need to be made in order to turn water on and someone must be present at the service address at the time of the appointment.                

6. Move In / Closing Date*
   Move In / Closing Date
7. Richton Park Service Address*
9. First Name*
10. Last Name*
11. Phone Number*
12. Date of Birth*
    Date of Birth
14. Employer Information
16. Employer's Name*
17. Work Number
19. Address
20. City, State
21. Zip
23. You may upload your Settlement Statement and Occupancy Inspection to help save time
25. Settlement Statement
26. Occupancy Inspection
Leave This Blank:


28. 1. Receive an email copy of this form.
29. Email address

    This field is not part of the form submission.

30. Submit

* indicates a required field