2.  Water Service Disconnection Request

4. Instructions for Water Service Disconnection Request

   Please complete this form to request the disconnection of your water service. This form is intended for customers who are moving, selling a property, or otherwise no longer require water service at a specific address.

   Important Information:

   • Water disconnections are only processed Monday through Friday between the hours of 9:00 AM and 4:00 PM.

   • No disconnections are performed on weekends or observed holidays.

   If you have any questions or need assistance, please contact our office at 404-669-2100

6. Requestor's Name*
7. Requestor's Phone Number *
9. Requestor's Email *
11. Account Number

    Account Number consists of 8-digit numbers and 2- dashes. Example: 12-3456-78

13. Acct. #*
15. Disconnect Service Address *
17. City*
18. State*
19. Zip*
23. Disconnect Service Date and Time*
    Disconnect Service Date and Time

    Disconnect Service Date and Time

    Please note request for disconnection of service cannot be completed after 4:00pm.

25. Upload Valid Government-Issued I.D.*
27. Forwarding Address

    A forwarding address is required to receive your final bill and water deposit refund.

29. Forwarding Address Info*
31. City*
32. State*
33. Zip*
37. Check if you have read and understand the terms*

    1. I Agree
39. Signature*
40. Today's Date*
    Today's Date
Leave This Blank:


43. 1. Receive an email copy of this form.
44. Email address

    This field is not part of the form submission.

45. Submit

* indicates a required field