Account Update Form

Account Name:

Sewer Account Number:

Service Address: *

Service Address City, State, Zip:

Name of Person Submitting Request: *

Phone Number: *

Mailing Address Street:

Mailing Address City:

Mailing Address State:

Mailing Address Zip:

Email:

Close of Escrow Date (if applicable):

For Account Verification: (Last 4 of SSN) or (Date of Birth) *

By electronically signing, I am stating that I am the legal owner or have the legal authority over the real property identified above. I/we acknowledge responsibility for all charges up to the date of termination, which shall not precede the legal transfer of ownership.

I agree to the terms and conditions stated above and I understand by checking this box and typing my full name below, this constitutes a legal signature as the owner or legal representative of the above mentioned property. *

Signature: (Please type your full name.) *

Enter the text you see in the security image:

“ Our Mission is to provide a high quality public service reclaiming water at the lowest practical cost, while meeting the needs of our customers, ensuring public health and protecting the environment. ” - SMCFD