Final Water Bill Request ForM

Please complete the form below to request a final water bill. Please allow at least a week to process a final bill.

(*) = required

Name of person requesting the final read (*):
Phone number of person requesting final read (*):
Date you would like the meter read (*):
Service address (*):
Select ONE of the options below and fill in the required information:

Option 1:	MAIL Final Bill to
Name:
Street Address:
City, State, Zip:
Option 2:	FAX Final Bill to
Fax Number:
Attention:
Option 3:	I will PICK UP the Final Bill
Option 4:	EMAIL Final Bill
Email:

Security check (*):