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Request for Disclosure of Information

  1. Request for Disclosure of Information Maintained by the 
    City of Rosenberg Utility Department

  2. Information in your City of Rosenberg Utility Department customer account record, including information regarding customer usage, services, and billing, including amounts billed or collected for utility usage, is generally excepted from discloser under Texas Government Code, Chapter 552 (Public Information Act). *However, the Texas Utilities Code, Chapter 182 (Rights of Utility Customers) Provides that a customer of a government-operated utility may request that the government-operated utility to disclose personal information in a customer's account record, including the customer's address, or any information relating to the volume or units of utility usage or the amounts billed to or collected from the individual for utility usage. Additionally, a customer or a representative of the customer may receive information excepted from disclosure if the information directly relates to utility service provided to the customer and is not otherwise confidential by law. 

    This form enables you to request disclosure of certain information under Texas Utilities Code, Chapter 182. If you wish to request disclosure of your information, please check the boxes below and submit this form.

  3. Account Information

  4. Service Address

  5. Release of information*
  6. You may rescind your request for disclosure by providing the City of Rosenberg Customer Service Department written notice. A government-operated utility or an officer or employee of a government-operated utility is immune from civil liability for a violation of Texas Utilities Code, Chapter 182, Subchapter B. 

    *Confidentiality under Chapter 182 does not prohibit a government-operated utility from disclosing personal information in a customer's account record to: (1) an official or employee of the state, a political subdivision of the state, or the United States acting in an official capacity; (2) an employee of a utility acting in connection with the employee's duties; (3) a consumer reporting agency; (4) a contractor or subcontractor approved by and providing services to the utility, the state, a political subdivision of the state, or the United States; (5) a person for whom the customer has contractually waived confidentiality for personal information; or (6) another entity that provides water, wastewater, sewer, gas, garbage, electricity, or drainage service for compensation. 

  7. Authorization

  8. 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.
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  10. This field is not part of the form submission.