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FINAL READ, WATER UTILITY SERVICE
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* Indicates required question
Final date for water read:
*
Note: Final meter reading will be done during normal business hours on the date selected. Water service cancellations can only be accommodated on weekdays. The Village is unable to cancel services on weekends or holidays.
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YYYY
First
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Customer Name/Account Holder
Your answer
Last
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Customer Name/Account Holder
Your answer
Phone Number
*
Your answer
Email
*
Your answer
Account Number (For account verification purposes, must be in the format listed on your utility bill) XX-XXXXX-XXX
*
For account number help, please contact (518) 273-2201
Your answer
Service Address to disconnect/cancel
*
Street Address
Your answer
City
*
Your answer
State
*
Your answer
ZIP / Postal Code
*
Your answer
Please indicate Apt/Floor number
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Email address/or fax number for final bill
*
Your answer
*
I hereby declare and affirm, by 'signing' my name(s) below, that I authorize the Village to disconnect my utility services at the service address listed above on date specified and to mail final bill to the forwarding address listed above.
Required
Please type in your name as your "signature"
*
Your answer
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