Notice of Right to Request Confidentiality


THIS NOTICE IS BEING PROVIDED TO YOU TO INFORM YOU OF YOUR RIGHT AS A UTILITY CUSTOMER OF THE CITY OF MELISSA.

Pursuant to  §182.051 et. seq., Texas Utilities Code, as amended, government-operated utilities are required to notify customers of their rights to confidentiality.

You are hereby informed that you have the right to request confidentiality of your personal information contained in our records. "PERSONAL INFORMATION" AS DEFINED BY THE STATUTE: MEANS AN INDIVIDUAL'S ADDRESS, TELEPHONE NUMBER OR SOCIAL SECURITY NUMBER.

Should you have any questions, please contact Utility Billing at (972) 838-2035, option #2 or via Email.

To exercise your rights, please complete the following form.  


PLEASE BE ADVISED THAT THE CONFIDENTIAL INFORMATION DESCRIBED BELOW IS SUBJECT TO RELEASE UNDER CHAPTER 552, TEXAS GOVERNMENT CODE, AS AMENDED ("PUBLIC INFORMATION ACT"), UNLESS YOU ELECT THE FIRST OPTION.

Please select one of the following options to indicate your preference:


  YES, I hereby request, pursuant to §182.051, et. seq., Texas Utilities Code, as amended, that my personal information and any information relating to utility usage, amounts billed to or collected from me for utility usage ("Confidential Information") maintained by the City of Melissa's Utility Billing Department REMAIN CONFIDENTIAL.

  NO, my Confidential Information may be released for any and all purposes.

Account Holder Name: 
Service Address: 
City of Melissa Account Number (optional): 
Driver's License Number: 


  I understand that by completing this form confirms my choice regarding confidentiality and my signature is not required. 

 I also understand that I have the right to rescind  (cancel) my request for confidentiality at any time.  

You may also submit your request for confidentiality as an attached PDF with signature if you prefer.