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Account Update Form
There are some errors in your form.
Account Name:
Sewer Account Number:
Service Address:
*
Service Address City, State, Zip:
Apache Junction, AZ 85119
Apache Junction, AZ 85120
Type of Customer:
*
Owner
Lender
Broker
Authorized Representative
Power of Attorney
Reason for Change:
Address Change
Trustee Sale
Change of Name
Change of Ownership
Other (please specify)
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:
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“
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