Forms • Start/Stop Service Request

Start/Stop Service Request

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To Start Service

Service Address *
City *
State
Zip
Your Name *
Name(s) on the account *
Owner or Tenant?*
For tenant accounts a signed copy of Lease or Rental Agreement is required.	Convert to PDF? (DOC, DOCX, XLS, XLSX, TXT)
Request Date for Service
Phone Number
Secondary Phone Number
Billing Address
City
State
Zip
Email Address

*Western Staff will contact you to verify information before service is started.

To Stop Service

WATER WILL BE SHUT OFF ON THE STOP SERVICE DATE
Your Name
Service Address
City
State
Zip
Stop Service Date
Forwarding Address
City
State
Zip
Phone Number
Email Address

* indicates required fields.