Antioch, CA · Contra Costa County
Water Service Disconnection Form 2026
Water account holders use this form to request disconnection of water service and provide a stop-service date, forwarding address, and reason for termination.
What this form is
This form lets an applicant request disconnection of a City of Antioch water account and acknowledge that they are authorized to update the account. It asks for the account number, stop-service date, service and forwarding addresses, contact details, identification information, and reason for termination. Requests are scheduled for the next business day unless a later date is provided; same-day service requires a $193 fee.
Who needs it
A person authorized to update a City of Antioch water account should complete this form when requesting that water service be disconnected.
How to submit it
Submit it to the city department named on the form; check the city website for current contact details.
About notarization
This form is signed without a notary; it mentions no notarized attachment or sworn step, and the applicant signs to acknowledge authorization.
How to submit this form
- 1
Download The Form
Download the Water Service Disconnection Form 2026.
- 2
Complete The Form
Enter the requested account, service, identification, contact, and termination details.
- 3
Sign The Acknowledgment
Sign to acknowledge that you are authorized to update the City of Antioch water account.
- 4
Submit To The City
Submit the form to the city department named on it; check the city website for current contact details.
Frequently asked questions
- What does the Water Service Disconnection Form request?
- It requests water service disconnection and asks for the account number, stop-service date, addresses, contact details, identification information, and reason for termination.
- Who should complete the disconnection form?
- The applicant acknowledges that they are authorized to make updates to the City of Antioch water account.
- How do I submit the Water Service Disconnection Form?
- Submit it to the city department named on the form; check the city website for current contact details.
- Do I need a notary for the Water Service Disconnection Form?
- No. The form is signed without a notary and mentions no notarized attachment or sworn step; the applicant signs to acknowledge authorization.
Need something notarized?
This Water Service Disconnection Form 2026 doesn’t need a notary — but if you have another Antioch form that does, a commissioned online notary can help.