Andersonville, GA · Sumter County
Utility Service Disconnection Request
Account holders submit this form to the City of Andersonville Utility Office to request disconnection of water, natural gas, or sewer service.
What this form is
This form lets an account holder request disconnection of water, natural gas, or sewer service from a City of Andersonville utility account. It asks for account and service details, a requested disconnection date, forwarding contact information, and whether the property is owned or rented. The signer certifies they are the person named and authorizes disconnection in their name.
Who needs it
An account holder who wants the City of Andersonville to disconnect water, natural gas, or sewer service at their service address needs this form.
How to submit it
Submit the completed form to the City of Andersonville Utility Office. The document does not list an address, email, portal, or fee.
About notarization
This document is signed and dated without a notary; it asks the signer to certify their identity and authorize service disconnection.
How to submit this form
- 1
Download The Form
Download the Utility Service Disconnection Request.
- 2
Complete The Form
Enter account and service details, the requested disconnection date, forwarding information, and the applicable service and property information.
- 3
Sign And Date
Sign and date the certification authorizing disconnection of service in your name.
- 4
Submit To The Utility Office
Submit the completed request to the City of Andersonville Utility Office.
Frequently asked questions
- What does the Utility Service Disconnection Request do?
- It lets an account holder request disconnection of water, natural gas, or sewer service and provide account, service, forwarding, and contact information.
- How do I submit the Utility Service Disconnection Request?
- Submit the completed form to the City of Andersonville Utility Office. The form does not provide an address, email, online portal, or fee.
- Do I need a notary for the Utility Service Disconnection Request?
- No. The document is signed and dated without a notary; the signer certifies their identity and authorizes service disconnection.