Utility Services Cancellation Form

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Cancel Utility Service

To minimize delays, please fill out the form completely. Service may only be canceled during normal business hours. Please enter the last four digits of the primary account holder's social security number to verify identity. For business accounts, enter the last four digits of the tax identification number.

If you have any questions or need to speak to someone in our office, please call (626) 932-5517. Sections marked with an asterisk (*) are required.

Please correct the fields below:

Please correct the field(s) marked in red below:

Service Information

*

Service Information

What day would you like to cancel service?

What is the service address?

Utility Account Information

*

Utility Account Information

What is the full name on this account?

Please provide the full name of the person making request:

What is the customer number?

Primary Phone Number?ext.

What is the account number?

Alternate Phone?ext.

Applicant Type? Are you the...

Applicant Type? Are you the...

Owner

Renter/Tenant

Management Company/Business

Account Holder Verification

*

Last Four Digits of Tax ID or Social Security Number (SSN)

Final Bill Address - Where would you like the last bill to be mailed?

*

Final Bill Address - Where would you like the last bill to be mailed?

Full Name

City

Address Line 1

State

Address Line 2

Zip Code

We recommend that you enter in your email address below to have a copy of the submission emailed to you.

To receive a copy of your submission, please fill out your email address below and submit.
Email Address

City of Monrovia

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