E-Gov Services Midland

Water Service (Temporary or Permanent) Termination Request

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Use this form to request temporary or permanent termination of water service to an address. This form is ideal for those leaving Midland for the winter, or moving to a new address. Do not use this form to transfer water accounts between two parties, as the service to the address will be terminated.

* Information is required.

Contact Information

* First Name:
* Last Name:
* Email:
* Daytime Phone:	() –
Address:
City:
State:
ZIP:

* Enter the address where you wish service to be terminated.

* Will the home be heated during the winter?
To avoid a frozen meter charge, the technician needs to pull the meter in homes that are not heated during winter months.

* What date does the service need to be terminated?
Note: The date must be a business day and also must be at least 2 working days from the date of form submission for the request to be processed.

* What time is best for you to have the service technician stop at your home?
Note: An adult must be present when the technician stops at the home.

Enter a new billing address where the final bill will be mailed.
Note: An address is required because water bills will NOT be forwarded by the Post Office.

Check here to have email confirmation of this request sent.

* Information is required.

Notes:

When you submit information through this form, you will receive a Tracking Number. You can track the status of your request by entering your tracking number in the field provided on the "Services and Information Requests" page.

Internal Use Only, Leave Blank:
Please leave this field blank and remove any values that have been populated for it.