Pilot Mountain, NC · Surry County
Request for Final Billing on Utility Account
Utility customers use this form to request that Pilot Mountain discontinue service and issue a final bill for their account.
What this form is
This form requests discontinuation of utility services on a specified date and acknowledges that the customer will receive a final bill. It asks for the customer’s name, account number, phone numbers, forwarding address, signature, and date. The form also explains how the account deposit will be applied and that the customer remains responsible for any amount owed after that deposit is applied.
Who needs it
A utility account customer who wants Pilot Mountain to discontinue service and send a final bill should complete this request.
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 customer signs and dates the request, and no notarized or sworn attachment is mentioned.
How to submit this form
- 1
Download The Form
Download the Request for Final Billing on Utility Account PDF.
- 2
Complete The Request
Provide your account number, requested discontinuation date, phone numbers, forwarding address, signature, and date.
- 3
Review The Account Terms
Read the form’s statements about the final bill, deposit, and responsibility for any remaining amount owed.
- 4
Submit To The City
Submit the completed request 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 Request for Final Billing on Utility Account?
- No. The customer signs and dates this request; it does not mention a notarized or sworn attachment.
- How do I submit the final billing request?
- Submit it to the city department named on the form; check the city website for current contact details.
- What information does the form request?
- It asks for the account number, requested service discontinuation date, phone numbers, forwarding address, and customer signature and date.
- What happens to the account deposit?
- The form says the deposit will be applied to bills owed in the customer’s name or account. The customer is responsible for any amount still owed afterward.
Need something notarized?
This Request for Final Billing on Utility Account doesn’t need a notary — but if you have another Pilot Mountain form that does, a commissioned online notary can help.