Harrisburg, IL · Saline County
Water Termination Form
Current occupants or owners use this form to ask Harrisburg to terminate water service at a property and provide a forwarding address.
What this form is
The Water Termination Form lets the current occupant or owner request that water service be terminated at the listed property. It asks for the date, customer name and phone number, service address, forwarding address, and customer signature. The signer also certifies their relationship to the property and accepts responsibility for any balances due and their payment.
Who needs it
A current occupant or owner who wants Harrisburg to terminate water service at the property listed on the form should complete it.
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 form.
How to submit this form
- 1
Download The Form
Download the Water Termination Form.
- 2
Complete The Form
Enter the date, customer name and phone number, service address, and forwarding address.
- 3
Review And Sign
Confirm the certification and responsibility for balances due, then sign the form.
- 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 does the Water Termination Form request?
- It requests termination of water service at a property and asks for customer and service details, a forwarding address, and the customer’s signature.
- Who can complete this form?
- The signer certifies that they are the current occupant or owner of the property where they want water service terminated.
- Do I need a notary for the Water Termination Form?
- No. This form is signed without a notary; the signer just signs and dates it.
- How do I submit the Water Termination Form?
- Submit it to the city department named on the form; check the city website for current contact details.