Forms • Snohomish, WA • CivicEngage

Account Change Request Form

Leave This Blank:

Today's Date*

Service Address (98290 zip code only)*

Account Number

First and Last Name*

Email*

Phone Number*

Choose one of the following:*

	I purchased a house (new owner)
	I would like to change my garbage service
	I would like to change my name/address

Move In/Out Date*

Mailing Address*

City*

State*

Zip*

Would you like to receive paper bills, e-bills, or both?

Further Comments

* indicates required fields.