Chino Valley, AZ · Yavapai County
Termination of Utility Services
Chino Valley utility customers use this form to request that water or sewer service be turned off at a specified service address.
What this form is
Use this form to request termination of Town of Chino Valley water or sewer service. It asks for the account number, service address, requested turn-off date, requester contact information, and an authorized signature. The form notes that one-business-day notice is required and lists the available shut-off hours. Customers who use Xpress bill pay must separately stop automatic payments through that provider.
Who needs it
A Chino Valley water or sewer account holder or authorized requester who wants service turned off at a service address should complete this form.
How to submit it
The form lists the Utilities Department at 202 N. State Route 89, Chino Valley, Arizona 86323, and [email protected]. It also lists 928-636-6084.
About notarization
This document is signed without a notary; the requester provides an authorized signature and date, and the form lists no notarized or sworn attachment.
How to submit this form
- 1
Download the Form
Download the Termination of Utility Services form.
- 2
Complete the Request
Enter the account number, service address, requested turn-off date, contact information, and authorized signature and date.
- 3
Allow Required Notice
Choose a requested turn-off date that allows the one-business-day notice stated on the form.
- 4
Submit to the Utilities Department
Use the Utilities Department address or email listed on the form.
Frequently asked questions
- Do I need a notary for the Termination of Utility Services form?
- No. The form asks for an authorized signature and date and does not include a notary block. The signer just signs and dates it.
- How do I submit the utility service termination form?
- The form lists the Utilities Department at 202 N. State Route 89, Chino Valley, Arizona 86323, and [email protected]. It also lists 928-636-6084.
- How much notice does the form require?
- The form states that one-business-day notice is required for a requested service turn-off.
- Do I need to stop Xpress bill pay separately?
- Yes. The form says to call Xpress bill pay at 1-800-720-6847 or log in to the account and disable automatic payments.