Start/Stop Utility Service

2. Request Type*

   1. Start New Service & Open Account
   2. Stop Service & Close Account

3. Date to Start Service*
   Date to Start Service

4. Date to Stop Service*
   Date to Stop Service

   Date cannot be prior to today's date.

5. Customer Type*

   1. Owner
   2. Renter
   3. Property Manager/Realtor

7. First Name*

8. Last Name*

10. Service Address*

11. Is Mailing Address Same as Service Address?*

    1. Yes
    2. No

13. Forwarding Address*

15. City*

16. State*

17. Zip*

19. Mailing Address*

21. City *

22. State*

23. Zip*

25. Contact Phone*

26. Email Address*

28. Last 4-digits of your SSN#*

29. Drivers License #*

30. State of Issuance*

    1. WA
    2. Other

32. Additional Responsible Party*

    Do you want to add an additional person to the utility account?

    1. Yes
    2. No
34. First Name

    We may need to abbreviate the name provided in order to fit within our utility billing fields.

35. Last Name

37. Comments

    Please provide any additional information

Leave This Blank:


38. Submit

* indicates a required field