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2. This form is for ending water, sewer and/or garbage service only.
4. Name on Account*
5. Account Number*
7. Service Address*
9. Customer Phone Number*
10. Email Address*
12. End Service Date*
    End Service Date
14. Forwarding Address #1*
15. Forwarding Address #2 (apt. #, suite, building, floor, etc.)
17. City*
18. State*
19. Zip Code*
21. Confirmation of Your Submission
    Upon hitting the Submit button, you will receive an immediate confirmation screen that your request has been successfully sent to the Water Billing Department. Please contact our office at 713-475-5566 to verify the date to discontinue services. A 24-hour notice is required for disconnection of service. If you would like "Same Day" service, a fee of $25 must be paid in advance.
    
    If the requested cancel services date falls on a weekend or holiday, we reserve the right to move the requested date to the next business day.
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23. 1. Receive an email copy of this form.
24. Email address

    This field is not part of the form submission.

25. Submit

* indicates a required field