Residential Commercial Appliances Safety About Contact PAY BILL Residential Application Home/Residential Application Save time by filling out the form below so it will be waiting at the office when you come in to establish service, or download the form, print and fill out. Bring it with you to our main office in Fort Payne or Centre. Have you ever had service with DC Gas before?YesNo Marital Status: MarriedSingleWidowDivorced Applicant's Full Name Mailing Address City State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Washington DC Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming  Zip Service Address City State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Washington DC Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming  Zip Home Telephone # Cell Phone Email Two forms of identification are required. Please see the list of acceptable documents. Social Security # Driver's License # State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Washington DC Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming  Employer Employer Address Employer's Telephone # Spouse's Name Spouse's Cell Phone # Spouse's Employer Spouse's Employer Address Spouse's Employer's Telephone # Relative Relative Telephone # Relative Address I rent this property from I own this property By inputting your name below, you certify that all statements made by you on this application are true and complete to the best of your knowledge. Name Need Help? Our customer service team is ready to answer any of your questions! Call us at 256.845.3731 or email us and we'll get back with you as quickly as possible. DEKALB COUNTY LOCATIONS DeKalb-Cherokee Counties Gas District Main Office 1405 Gault Ave South Fort Payne, AL 35967 256.845.3731 Toll Free: 800.239.5606 Fort Payne Customer Service Center 1411 Chitwood Ave SE Fort Payne, AL 35967 256.845.8932 CHEROKEE COUNTY LOCATION Centre Customer Service Center 1401 W. Main St. Centre, AL 35960 256.927.5925 ACCEPTS PAYMENTS FOR DC GAS Collinsville Utilities 170 Main St. Collinsville, AL 35961 © DeKalb-Cherokee County Gas District | Policies