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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