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Water Termination Form
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WATER TERMINATION FORM
Please complete this form to allow us to finalize your water account with the City of Nassau Bay.
This form must be submitted at least one business day in advance to allow us enough time for your account to be processed.
Water Service will be shut-off if we do not have the new owner/renter’s information on file to establish new service in their name.
Name(s) on Account:
(If date requested falls on a weekend, the account will be finalized on the following business day.)
Final Billing Address:
City / State
Name of Person Making Request:
Contact Phone Number:
Please type your name acknowledging the above information you have provided is correct.
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