"*" indicates required fields I certify that I request to have electric and/or water service(s) in my name turned off at the following address and I understand that this constitutes a legal digital signature and legally authorized turn off date:Name* First Last Date* MM slash DD slash YYYY Email* Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code I wish to have the deposit(s) associated with this account (select one):* Applied to the final bill for this service location Remain on my customer account to be used for future service locations I understand that the Final Bill will be due and payable within fifteen (15) days of receipt.I authorize the final bill or Deposit to be mailed to the following address:* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code CommentsThis field is for validation purposes and should be left unchanged.