Utility Service(s) Termination Request

Utility Service(s) Termination Request

This form is used to terminate utility services.

Do not report emergencies with this form!
Dial 9-1-1 for all emergencies!
 
 
Prior to the termination of any services, City Hall must receive a photocopy of the Customer's Identification. Please fax the Indentification to (229) 246-7311 to the attention of the BILLING COORDINATOR.

 

* Denotes a required field
 

Customer Information

*
 
*
Social Security Number*
--
 
*
Daytime Telephone 
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Evening Telephone 
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Mobile Telephone 
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*
*Your Utility Account Number can be found on your bill. We MUST have this number to process this request.
 

Requested Services

*
Would you like to terminate your water service?*
If yes, when would you like your water service terminated? 
 
Would you like to terminate your Natural Gas services?*
If yes, when would you like your Natural Gas services terminated? 
 

*Please type in all capital letters to electronically sign.
*
Date*
  
 


 



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