Ironton, OH · Lawrence County
Water Disconnection Request
Water customers use this form to request that the City of Ironton disconnect service at a specified address.
What this form is
This form lets a water customer request disconnection of water service at a listed address. It asks for the account number, customer and billing details, property type, and reason for disconnection; the requester signs to certify the information is accurate.
Who needs it
A water customer requesting disconnection at an address, including for an unoccupied property or temporary repairs, should complete this form.
How to submit it
Email the form to [email protected] or fax it to (740) 533-6089. Include a copy of the driver’s license when submitting by email or fax.
About notarization
This document is signed without a notary; the signer certifies the information is accurate, and no notarized attachment or related step is listed.
How to submit this form
- 1
Download The Form
Download the Water Disconnection Request.
- 2
Complete The Form
Enter the account number, customer and billing details, service address, property type, and reason for disconnection.
- 3
Sign And Gather The Copy
Sign the form to certify the information is accurate. Include a copy of the driver’s license if submitting by email or fax.
- 4
Send The Request
Email the form to [email protected] or fax it to (740) 533-6089.
Frequently asked questions
- What is the Water Disconnection Request used for?
- Water customers use this form to ask the City of Ironton to disconnect service at a specified address and provide the account, property, and reason details.
- Do I need a notary for the Water Disconnection Request?
- No. The form calls for the customer’s signature to certify the information is accurate. It lists no notarized attachment or related step.
- How do I submit the Water Disconnection Request?
- Email it to [email protected] or fax it to (740) 533-6089. Include a copy of the driver’s license if submitting by either method.
Need something notarized?
This Water Disconnection Request doesn’t need a notary — but if you have another Ironton form that does, a commissioned online notary can help.