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15520 Crestwood Dr., Basehor, KS 66007
913-724-7000
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–
Step
1
of 2
I am
*
Selling my home
Renting
Account Name (as it appears on your bill):
*
First
Last
Property Address
*
Address Line 1
Address Line 2
City
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District of Columbia
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State
Zip Code
Forwarding Address (address for final bill)
*
Address Line 1
Address Line 2
City
— Select state —
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
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Michigan
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Ohio
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Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Contact Phone 1
*
Contact Phone 2
Email
*
Stop Service Date
*
Landlord Name
*
Landlord Phone
*
Final bill
*
I hereby acknowledge that I may owe a final bill and agree to pay said bill.
Agree to transfer
*
I hereby agree that I am transferring the water benefit unit (water meter) to the new owner located at the above address.
Processing time
*
I agree that I must allow a minimum of 3 business days for processing of this request and to obtain a final meter reading. I further understand that weekends and holidays are not counted in the 3 business days. If the stop date falls on a weekend or holiday, the processing of the application will occur on the next business day.
By signing my name electronically, I am agreeing that my electronic signature is the legal equivalent of my manual signature on this application.
*
***Please allow 3 business days for processing of this form.***
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