Indicates required field Use this form to stop service at your current address and start service at a new address. Transferring Wastewater Service Customer Information Customer Number Found on the right upper corner of your bill Disconnect Date Account Last Name Account First Name Service Address Address City/Town State/Province ZIP/Postal Code Mailing Address if Different Than Service Address Mailing Address City/Town State/Province ZIP/Postal Code Would you like to transfer your recurring ACH information to your new account? - None -YesNoNA for existing recuring ACH draft customers only Relationship to Customer Relationship to Customer - Select -SelfChildSpouseCare GiverExecutorReal Estate AgentOther… Enter other… Primary Phone Number Phone Type Cell Home Business Emergency Alternate Phone Number Phone Type Cell Home Business Emergency E-mail Address New Account Information Service Start Date New Service Address Address City/Town State/Province ZIP/Postal Code CAPTCHA This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.