East Dubuque, IL · Jo Daviess County
Application for Termination of Service
East Dubuque residents use this form to request termination of city services and provide a forwarding address for the final bill.
What this form is
This form tells the City of East Dubuque that you want services terminated at an address. It asks for the account holder’s name, service address, requested termination date, forwarding address, and applicant signature; it also provides spaces for new-owner or landlord details. The form says to notify the city 30 days before moving and states that the applicant is responsible for charges incurred while services are in their name.
Who needs it
A customer moving from an East Dubuque service address can use this form to request termination and provide a forwarding address for the final bill.
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 and dated without a notary; it lists no notarized or sworn attachment or related step.
How to submit this form
- 1
Download The Form
Download the Termination of Service form from this page.
- 2
Complete The Form
Enter the applicant name, service address, requested termination date, forwarding address, and any applicable new-owner or landlord details.
- 3
Sign And Date
Sign and date the applicant section; the form does not require notarization.
- 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 Termination of Service form?
- No. The form asks the applicant to sign and date it, but does not require a notary or list a notarized or sworn attachment.
- How do I submit the Termination of Service form?
- Submit it to the city department named on the form; check the city website for current contact details.
- When should I notify the city that I am moving?
- The form says it is your responsibility to notify the City 30 days prior to moving.
- What information does the form ask for?
- It asks for the applicant’s name, service address, requested termination date, forwarding address, and signature. It also has spaces for new-owner or landlord details.