Brawley, CA · Imperial County
Water Service Cancellation Form
Brawley utility customers use this form to request discontinuation of water service and provide the account address, requested date, and forwarding information.
What this form is
This form is a written request to discontinue water service from the City of Brawley Utility Department. The document says a formal written request with a signature is required to stop service; otherwise, billing will continue. It asks for the owner or tenant’s name, account address, requested discontinuation date, signature, ending reading, date, and forwarding address.
Who needs it
An owner or tenant who wants water service discontinued at an account address in Brawley needs to submit a signed written request.
How to submit it
Send the signed request to the Utility Department, City of Brawley, 400 Main Street, Brawley, CA 92227. The form lists the Utility Department phone number as (760) 344-1550.
About notarization
This document is signed and dated without a notary; it lists no notarized or sworn attachment, so the signer just signs and dates it.
How to submit this form
- 1
Download The Form
Download the Water Service Cancellation Form.
- 2
Complete The Request
Enter the owner or tenant’s name, account address, requested discontinuation date, ending reading, date, and forwarding address.
- 3
Sign The Form
Sign the written request. The form does not list an attachment to gather.
- 4
Submit To The City
Send the signed request to the Utility Department at 400 Main Street, Brawley, CA 92227.
Frequently asked questions
- What does the Water Service Cancellation Form request?
- It requests the owner or tenant’s name, account address, requested discontinuation date, signature, ending reading, date, and forwarding address.
- Who should use this water service cancellation form?
- An owner or tenant requesting that water service be discontinued at an account address can use this form to make the required written request.
- Do I need a notary for the Water Service Cancellation Form?
- No. The form calls for a signature and date, not notarization, and it lists no notarized or sworn attachment.
- How do I submit the Water Service Cancellation Form?
- Send the signed request to the City of Brawley Utility Department at 400 Main Street, Brawley, CA 92227.
Need something notarized?
This Water Service Cancellation Form doesn’t need a notary — but if you have another Brawley form that does, a commissioned online notary can help.