To terminate your utility account, please complete the form below: <form-template> <fields> <field type="text" subtype="text" required="true" label="Customer Name" class="form-control text-input" name="text-1659043132037"></field> <field type="text" subtype="text" required="true" label="Service Address" class="form-control text-input" name="text-1659043142045"></field> <field type="date" required="true" label="Move out Date" class="form-control calendar" name="date-1659044416793"></field> <field type="text" subtype="text" required="true" label="Mailing Address" class="form-control text-input" name="text-1659043157329"></field> <field type="header" subtype="h2" label="For Office Use Only" class="header"></field> <field type="text" subtype="text" label="Account # ____________________" class="form-control text-input" name="text-1659043206971"></field> <field type="text" subtype="text" label="Received date: ______________ Processed by: ________________" class="form-control text-input" name="text-1699475741000"></field> <field type="text" subtype="text" label="Meter Reading: ______________ Completed by: ________________ Completed on: ________________" class="form-control text-input" name="text-1659043221373"></field> <field type="text" subtype="text" label="water turned off on: ______________ Completed by: ________________" class="form-control text-input" name="text-1699475817929"></field> <field type="text" subtype="text" label="Final Bill Processed by: ______________ Completed on: ________________" class="form-control text-input" name="text-1699475891321"></field> <field type="text" subtype="text" label="Date Refund Processed: ______________ Date Refund Cheque Mailed: ________________" class="form-control text-input" name="text-1699476280276"></field> <field type="text" subtype="text" label="Date Final Bill sent: ______________" class="form-control text-input" name="text-1699475940577"></field> <field type="text" subtype="text" label="Date Refund Processed: ______________ Date Refund Cheque Mailed: ________________" class="form-control text-input" name="text-1699476471331"></field> </fields> </form-template> Submit Submitting...