Form Submission Complete

2. Request for Termination of Service

   A closing bill will be mailed to your forwarding address within approximately two weeks of termination. If the closing balance is a credit, a refund check will be mailed to the forwarding address within approximately 60 days of termination.  

   You will receive a confirmation email from a representative once the request is completed. If a confirmation is not received, your request is not completed and the account will remain active.

4. Name on Account*

   First and Last Name or Business Name

5. Account number*

   Example: AC1234-001

7. Service Address*

   Street Address

8. Requested Turn-Off Date: mm/dd/yyyy*

   (Requests for termination must be performed on a business day. Requests for termination will be processed the following business day if received by 5:00 pm Monday - Thursday, and by 4:00 pm on Friday, except for holidays.)                

10. Contact Information
12. Forwarding Address*
13. City*
14. State*
15. Zip Code*
17. Phone Number*
18. Email*
20. Copy of valid photo identification or W-9*

    Driver's License is the most common form of identification for Residents.

    W-9 form is required for Businesses only.

Leave This Blank:


22. 1. Receive an email copy of this form.
23. Email address

    This field is not part of the form submission.

24. Submit

* indicates a required field