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Final Account Request
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Account Information
Name on Account
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Account Number
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Date for Account to be finalized
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Date for Account to be finalized
Service Address
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Address, City, State, Zip
My Account has been set - up for ACH/Automatic Bank Draft
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Send My Final Bill To:
Mailing Address
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Phone:
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Acknowledgement and Signature
I am requesting that my Water/Wastewater account be finalized. I understand that I am responsible for the cost of water/wastewater service up to the date the account is finalized. I understand that my auto-payment from my Checking/Savings account will be cancelled with this request , and I understand I will be responsible for paying the final bill manually. The Utilities Department will endeavor to act upon telephone , e-mail, or verbal orders to discontinue service, but in the event of a dispute, only a signed written notice will be considered proof of notification. If I do not pay my account in full I understand that any final balances can be transferred to a current account and is due immediately or that my past due finalized amount will be sent to a collection agency.
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