Notification of Right of Confidentiality of Customer Information

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Section 182.052 of the Texas Utilities Code requires government-operated utilities to notify customers of their right to confidentiality. You are hereby informed that you have the right to request confidentiality of your address, telephone number, social security number and any information relating to the volume or units of utility usage and the amounts billed to or collected from you for utility usage, as contained in our records.

Please be aware that if you requested confidentiality in the past, you also have the right to cancel that request for confidentiality.

To exercise your rights, please complete the information requested on this form and return it to the address below. If you have requested confidentiality of your account information in the past, you do not need to resend.

Confidentiality Choice

I hereby request confidentiality.

I hereby cancel my request for confidentiality and give permission to disclose my information.

Name

First Last

Service Address

Street Address Address Line 2 City State ZIP Code

Phone

Signature

Date

This field is for validation purposes and should be left unchanged.

Notification of Right of Confidentiality of Customer Information

Lakeway Municipal Utility District

Customer Support

Quality Matters

Six Years