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Residential Account Change Request Form
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This form has been modified since it was saved. Please review all fields before submitting.
Today's Date
*
Today's Date
Service Address (98290 zip code only)
*
Account Number
Email
*
Choose one of the following:
*
I'm moving out (renter) - go to Part A
I'm moving in (renter) - go to Part B
I sold my house (owner) - go to Part C
I purchased a house (new owner) - go to Part D
I would like to change my name/address - go to Part E
I would like to sign up for e-bills (go paperless):
Part A - I'm moving out (renter)
Move Out Date
Move Out Date
First Name
Last Name
Forwarding Address
Forwarding Address
City
State
Zip
Phone Number
Part B - I'm moving in (renter)
Move In Date
Move In Date
First Name
Last Name
Mailing Address
City
State
Zip
Phone Number
Part C - I sold my house (owner)
Closing Date
Closing Date
First Name
Last Name
Forwarding Address
Forwarding Address
City
State
Zip
Phone Number
Part D - I purchased a house (new owner)
Closing Date
Closing Date
First Name
Last Name
Mailing Address
City
State
Zip
Phone Number
Part E - I would like to change my name/address
First Name
Last Name
Mailing Address
Mailing Address
City
State
Zip
Phone Number
How would you like to receive your bills?
-- Select One --
Paper Bills
e-bills (make sure email address is provided)
Both paper and e-bills
Choose paper, e-bills, or both
Further Comments
Leave This Blank:
Receive an email copy of this form.
Email address
This field is not part of the form submission.
Submit
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