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2. City of Forney - Water/Sewer Disconnection Request

   Disconnection requests may only be made by the Account Holder. Disconnections cannot be scheduled on a weekends or holiday. Plan three business days to implement the request.

4. Today's Date*
   Today's Date
5. Requested Disconnection Date*
   Requested Disconnection Date

   *Minimum notice is 72 Hours* Service changes are not scheduled on Holidays or Weekends, nor can disconnections be back-dated.

6. Account # *
8. Rent or Own*

   1. Rent
   2. Own
9. Property Owner Name
11. Service Address*
13. Billing Name*
15. Forwarding Street Address for Final Bill or Refund*
17. Forwarding Address City*
18. Forwarding State*
19. Forwarding Zip Code*
21. Home/Cell Phone*
22. Work Phone
24. Copy of Driver's License*

    Front photo of Driver's License or other Government issued ID.

26. Email Address*
28. Terms and Conditions

    I request to discontinue water service at the above property. I will not hold the City of Forney responsible for any property damage due to the water being turned off. I understand I will be billed for water consumption up to the time of the final reading. If a deposit is on file, I understand it will be credited to the final bill and that the final bill will be due within 15 days.

30. Electronic Signature of Applicant*
Leave This Blank:


32. Submit

* indicates a required field