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This document is a request form used by residents or businesses to disconnect or reconnect utility services. It captures essential information such as account number, owner name, service address, reason for disconnection, and acknowledges potential fees involved in the process. It also includes signatures from the applicant and village employee to verify the request.
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How to fill out utility service disconnection request

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How to fill out utility service disconnection request

01
Gather necessary information: Collect your account number, address, and the name on the account.
02
Obtain the form: Visit the utility company's website or contact customer service to request the disconnection form.
03
Fill out the form: Provide required details such as the requested disconnection date and reason for disconnection.
04
Review the information: Check the form for accuracy to ensure all required fields are complete.
05
Submit the form: Send the completed request via online submission, email, or by mail as instructed on the form.
06
Confirm receipt: Follow up with the utility company to ensure your request has been received and processed.

Who needs utility service disconnection request?

01
Anyone moving out of a residence.
02
Individuals or businesses wanting to discontinue utility services.
03
Tenants at the end of a lease who need to terminate service.
04
Property owners who no longer require utilities for properties they own.
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A utility service disconnection request is a formal request made by a customer to their utility provider to terminate or disconnect their utility services, such as electricity, gas, or water.
Typically, the account holder or registered customer of the utility service is required to file a utility service disconnection request.
To fill out a utility service disconnection request, provide necessary information such as account details, requested disconnection date, and personal identification information. Follow the specific format or form provided by the utility company.
The purpose of a utility service disconnection request is to officially notify the utility company that the customer wishes to terminate their utility services, either due to relocation, cancellation, or change in circumstances.
The information that must be reported includes the account number, customer name, service address, requested disconnection date, and contact information.
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