Jefferson, GA · Jackson County
Cancellation of Utility Services
Jefferson utility customers use this form to request disconnection of service and provide their forwarding address and desired disconnection date.
What this form is
This form lets a customer request cancellation of utility services at a Jefferson service address and provide a forwarding address. It asks for contact and account details, whether the customer rents or owns, a desired disconnection date, and a signature. The form says Jefferson does not provide same-day service, requires requests at least one business day ahead, and completes disconnects on weekdays from 8:00 am to 12:00 pm.
Who needs it
A customer who wants to disconnect utility service at a Jefferson service address should complete and sign this form.
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 document is signed without a notary; the signer just signs and dates the cancellation request.
How to submit this form
- 1
Download the Form
Download the Cancellation of Utility Services form for Jefferson.
- 2
Complete the Form
Enter your contact and account details, addresses, rent-or-own status, and desired disconnection date.
- 3
Sign and Date
Sign and date the form. No attachments are listed on the document.
- 4
Submit to the City
Submit it to the city department named on the form; check the city website for current contact details.
Frequently asked questions
- Do I need a notary for the Cancellation of Utility Services form?
- No. The form has a signature and date field but no notary block; the signer just signs and dates the cancellation request.
- How do I submit the utility cancellation form?
- Submit it to the city department named on the form; check the city website for current contact details.
- How far ahead should I request a utility disconnection?
- The form says to request a disconnection at least one business day in advance. It also says the city does not provide same-day service.
- What information does the cancellation form ask for?
- It asks for your name, service and forwarding addresses, account number, phone number, email, rent-or-own status, desired disconnection date, signature, and date.
Need something notarized?
This Cancellation of Utility Services doesn’t need a notary — but if you have another Jefferson form that does, a commissioned online notary can help.