Disconnect Service

Thank You For Your Valued Business.

Whether you’re moving or need to disconnect water to your property for another reason, we’re here to help.

Option 1: Compete the form below to submit your request online.

Option 2: Visit our Forms page to download the form, then submit the completed form in person or by mail.

Disconnect service Form

Today's Date:

Name

First

Last

Business Name: (If Applicable)

Phone

Account Number

Requested Disconnect Date:

Service Address

Address Line 1

Address Line 2

City

State

Zip Code

Forwarding Address

Address Line 1

Address Line 2

City

State

Zip Code

DL#: (Driver's License)

(For identity verification)

Apply Deposit?

Signature

Clear Signature

By digitally signing my name here, I agree that I am the account holder stated above and that I agree to my water supply being terminated on the disconnect date specified above.

Next Steps

You will receive a confirmation email within 2 business days confirming your disconnection date.

Need Assistance?

If you need assistance, our team is happy to to help answer your questions or guide your next steps.

Disconnect Service

Thank You For Your Valued Business.

Disconnect service Form

Next Steps

Need Assistance?

Attention! (Test)

Southwest Water Users

Attention! (tEST)

Test Attention!

Salem Water Users Board Meeting