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This is a request to cancel the previously set up automatic payment of your water bill for any reason. We must receive your request for cancellation at least 10 business days prior to the due date to discontinue automatic withdrawals. All information provided in this form is subject to Freedom of Information Act requests subject to State law.
By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.
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