Danielsville, GA · Madison County
Service Disconnect Form
Account holders or their representatives use this form to request termination of water or trash service at a City of Danielsville service location.
What this form is
The form records a request to disconnect water service, trash service, or both, along with a preferred disconnection date and the reason for the request. It asks for account and service location details, contact information, a forwarding address, and the requester’s relationship to the account holder if applicable. A copy of the driver’s license of the person closing the account is needed to issue a refund.
Who needs it
An account holder or their representative who wants to request disconnection of water or trash service in Danielsville needs 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 form is signed without a notary; include a copy of the person closing the account’s driver’s license if a refund is to be issued.
How to submit this form
- 1
Download The Form
Download the City of Danielsville Service Disconnect Form.
- 2
Complete The Form
Enter the account, service, date, reason, requester, contact, and forwarding address information, then sign the form.
- 3
Gather The Required Attachment
Include a copy of the driver’s license of the person closing the account if a refund is to be issued.
- 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
- Do I need a notary for the Service Disconnect Form?
- No. The form is signed without a notary. A copy of the driver’s license of the person closing the account is needed to issue a refund.
- How do I submit the Service Disconnect Form?
- Submit it to the city department named on the form; check the city website for current contact details.
- What services can I request to disconnect?
- The form lets you request termination of water service, trash service, or both. It also asks for your preferred disconnection date and the reason for the request.
- What information does the form ask for?
- It asks for the account number, account holder and service location details, requester information, contact numbers, forwarding address, preferred disconnection date, and reason for disconnection.
Need something notarized?
This Service Disconnect Form doesn’t need a notary — but if you have another Danielsville form that does, a commissioned online notary can help.