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Utilities Forms


If you require service connection at a new location, please fill out the form provided in the link below, and send along with all required documents to

Application For Service Request Form

Medical Alert Application

If you or someone who lives with you is dependent on electrically operated life-support equipment, you may apply for special consideration in case of interruption of service. If you provide us with a statement from your doctor and the company supplying the equipment, you will be given priority in the service restoration. We cannot guarantee uninterrupted service, nor can we always predict how long an outage will last, but we will make every attempt to restore service as soon as possible. Please print and fill out the medical alert form below, and fax it or bring it to our Customer Service Department along with a statement from your doctor and the company supplying the equipment.

If approved, Medical Alert will remain active on your account for one (1) year. At that time, if it still applies, please submit a new medical application for consideration. For more information call (856) 794-4021.

Medical Alert Application Form

Penalty Exemption

Eligible applicants for this program will have the late penalty charge waived on Electric and Water Utility bills.

Penalty Charge Exemption Application

Third Party Notification

Vineland Municipal Utilities is engaged in a program called Third Party Notification.  This program notifies property owners, or other concerned parties, of the possibility of discontinuance of service due to non-payment of past-due utility bills.  This program is especially beneficial to the elderly who, through no fault of their own, may forget to pay their bills.

Third Party Application Form

Deployed Military Discount

The City of Vineland recognizes the sacrifices of the men and women in our military and find it necessary to provide a benefit to assist those serving our Country during their deployment to relieve some of their burdens of protecting our country and providing for the needs of their families in their absence. The Deployed Military Member Utility Services Discount, provides a 5% reduction on both electric and water services to all military members who are currently deployed outside the U.S. and its territories.

Deployed Military Discount Form


The City of Vineland recognizes the sacrifices of the men and women in our military and the continued suffering and grief felt by their Gold Star Family members and other loved ones, and as such we wish to provide a benefit to assist the Gold Star Families in honor of their sacrifice.  The Gold Star Families Discount provides a 10% reduction on both the electric and water bills to immediate family members of a fallen service member who dies while serving in a time of conflict.

Gold Star Families Discount Form

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