Termination of Utility Service Online Form

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Please correct the field(s) marked in red below:

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*For problems or inquiries please contact 281.652.1603.

1
Effective Date
 *
2
Is this a temporary fire hydrant meter?  
Is this a temporary fire hydrant meter?
3

Requested by

Requested by
4

Service Holder

Service Holder
5
Name of Customer / Business
 *
6
Service Address
 *
7

Forwarding Address for Final Bill

 *
8

City

 *
9

State

 *
10

Zip Code

 *
11

Phone Number

 *
12

Cell Number

 *
13

Email Address

14

Customer Account Number

 *
15
The following statements must be checked for termination:
 *
The following statements must be checked for termination:
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