Going paperless offers a secure and convenient way to pay your bill online. It’s more timely than mail delivery and also reduces the amount of paper we use. And that means saving more trees, water and energy!

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Name

First Name (required)

Last Name (required)

Email (required)

Phone (required)

Okaloosa Gas Account # (required)

Okaloosa Gas Service Address (required)

City (required)

Zip Code (required)

I authorize Okaloosa Gas District to text my authorized phone number(s) with important account information or updates, including bill and payment notifications. (required)

Yes

I hereby authorize Okaloosa Gas District to email the above address with account information or updates, including bill and payment notifications. I acknowledge that by signing up I will no longer receive a paper bill in the mail, but my bill will be sent to the email address listed above. I understand that I must contact Okaloosa Gas District by phone or email if I decide to change my information or rescind the authorization. (required)

Yes

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I understand that by initialing below represents my digital signature.

Your Signature (required)

Confirm e-Signature

Review Electronic Records and Signatures Policy (required)

Read our Electronic Record and Signature Disclosure

I agree to use electronic records and signatures

Date (mm/dd/yyyy) (required)

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