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Request To Cancel Water Service

2. Requests to final a service are processed Monday thru Friday. Requests received after 2:00 PM are processed the following business day.

4. Customer Name*

6. Customer Number (Can be found on your bill)*

7. Phone Number*

9. Email*

10. Date to Final Service*
    Date to Final Service

    Date must be a future date. We cannot retroactively finalize services.

12. Who is putting in this request?*
    -- Select One --OwnerRenterOther

13. Would you like the final bill emailed?*

    1. Yes

    1. No

15. Other's Name

19. Service Address*

    Street Address or PO Box

21. City*

22. State*

23. Zip

27. Forwarding Address*

    Street Address or PO Box

29. City*

30. State*

31. Zip*

35. Status of Home or Business*
    -- Select One --Sold HomeSold Business PropertyLeased HomeLeased Business PropertyOther

Leave This Blank:


37. 1. Receive an email copy of this form.
38. Email address

    This field is not part of the form submission.

39. Submit

* indicates a required field