Grass Valley, CA · Nevada County
Utility Billing Discontinuance of Service Form
Property owners or authorized agents use this form to request that Grass Valley discontinue water service after a property sale or while a property is vacant.
What this form is
This form requests discontinuance of water service when a property has been sold or will be vacant. It asks for the service address, account and contact details, reason for discontinuance, and the applicable sale or vacancy information. For a sale, the escrow close date and title company name are required; for a vacant property, the requested date and owner’s signed declaration are required.
Who needs it
A property owner or authorized agent requesting water service discontinuance because the property was sold or will be vacant should complete this form.
How to submit it
Return the completed and signed form to the City of Grass Valley Public Works Department, 125 E Main Street, Grass Valley, CA 95945.
About notarization
This form has no notary block; the owner signs and dates it and makes a statement under penalty of perjury, but no notarization is indicated.
How to submit this form
- 1
Download The Form
Download the Utility Billing Discontinuance of Service Form PDF.
- 2
Complete The Form
Enter the service address, account and contact information, reason for discontinuance, and the information requested for the sale or vacancy.
- 3
Sign And Date
The owner or authorized agent completes the applicable declaration and signs and dates the form.
- 4
Return It To Public Works
Return the completed form to the City of Grass Valley Public Works Department, 125 E Main Street, Grass Valley, CA 95945.
Frequently asked questions
- Do I need a notary for the Utility Billing Discontinuance of Service Form?
- No. The form has no notary block, but the owner signs and dates it and makes a statement under penalty of perjury.
- How do I submit the Utility Billing Discontinuance of Service Form?
- Return the completed and signed form to the City of Grass Valley Public Works Department at 125 E Main Street, Grass Valley, CA 95945.
- What information is required when a property has been sold?
- The form asks for the escrow close date and title company name to stop service in the current owner’s name. It says incomplete forms will not be processed.
- What does the form require for a vacant property?
- For a vacant property, provide a requested discontinuance date and sign the declaration that the residence will be vacant and has no tenant occupying it.
Need something notarized?
This Utility Billing Discontinuance of Service Form doesn’t need a notary — but if you have another Grass Valley form that does, a commissioned online notary can help.