eClay Account Information System
Street Light Problem

Request for Outdoor Light Repairs
Use this form to report Outdoor Light Problems.



* Required Information

Account Number

Name
E-mail Address
* 

Search Address

Location search requires a minimum of 4 characters.
for example 1234 Main Street Apt 23
(type) 1234 main
Address Where the Outdoor Light is located?
 
If located in a subdivision provide subdivision name or provide city/town name
 
Number of Lights at this location 
Describe where the Outdoor Light is located on the property:
Describe the problem with the Outdoor Light:
A phone number is required in case we need to contact you to verify information
*Home Phone Number
*Day Time Phone Number & Extension
 ext.

Comments
Please verify information on this form before submitting.