Riverdale, IL · Cook County
Affidavit to Disconnect Water Service for Emergency Only
Property owners or representatives use this Riverdale affidavit to authorize an emergency water service disconnection and acknowledge related responsibilities.
What this form is
Use this affidavit to request that the Village of Riverdale Water Department disconnect water service because of emergency circumstances. It asks for the date, property address, emergency reason, owner or representative’s name and contact details, and signatures; the signer also acknowledges possible costs and responsibilities. The form states that fees apply and that service restoration must be requested after the emergency is repaired.
Who needs it
A property owner or representative requesting an emergency water service disconnection from the Village of Riverdale needs this affidavit.
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 affidavit does not require a notary; the owner or representative signs and dates it, and no sworn attachment is mentioned.
How to submit this form
- 1
Download The Affidavit
Download the emergency water disconnection affidavit PDF.
- 2
Complete The Form
Enter the date, property address, emergency reason, owner or representative details, and requested signatures.
- 3
Check For Attachments
The form does not list any attachments to gather.
- 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
- What is the emergency water disconnection affidavit for?
- It authorizes the Village of Riverdale Water Department to disconnect water service to a property because of emergency circumstances.
- What information does the affidavit ask for?
- It asks for the date, property address, reason for the emergency, owner or representative information, and signatures. The signer also acknowledges responsibilities described on the form.
- Do I need a notary for the emergency water disconnection affidavit?
- No. This document does not require a notary; the owner or representative signs and dates it, and no sworn attachment is mentioned.
- How do I submit the emergency water disconnection affidavit?
- Submit it to the city department named on the form; check the city website for current contact details.
Need something notarized?
This Affidavit to Disconnect Water Service for Emergency Only doesn’t need a notary — but Illinois residents can notarize other documents online with a commissioned online notary.