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Move Out Request

2. 24 hour advance notice is required to cancel water service.
   Disconnects take place during normal weekly business hours.

   Disconnects take place during normal weekly business hours.

4. Name on Account*

5. Account Number*

7. Service Address*

   Please provide the address on the water bill where service should be discontinued.

9. Date to Turn Water Off*
   Date to Turn Water Off

   (Non-Holiday Weekdays Only)

11. Phone(s)*

    (Please give us the best phone number(s) to reach you with any questions or information.)

13. Final Bill Address *

    Please provide Name, Address, City + State + Zip where final refund/bill will be mailed.

15. Email*

    We will email you a copy of this request.

17. It is the customer’s responsibility to call our office (972-625-2741) and confirm the move out request was received.*

    1. I agree

    By clicking the confirmation you agree to the date for the disconnect.

Leave This Blank:


18. 1. Receive an email copy of this form.
19. Email address

    This field is not part of the form submission.

20. Submit

* indicates a required field