Van Horn, TX · Culberson County
Utility Disconnect Form
The Utility Disconnect Form lets a Town of Van Horn account holder request that utility service at an address be cut off.
What this form is
Account holders use this form to request that utility services be cut off effective on a date they provide. It asks for the account holder’s name and phone number, the service address, requested cutoff date, and a new mailing address if applicable; the signer also signs and dates it.
Who needs it
A Town of Van Horn utility account holder who no longer requires service at the listed address can use this form to request disconnection.
How to submit it
The form lists Town of Van Horn at 1801 W. Broadway, P.O. Box S17, Van Horn, Texas 79855, and phone number (432) 283-2050. It does not specify a submission method.
About notarization
This document is signed without a notary; the account holder just signs and dates the form.
How to submit this form
- 1
Download The Form
Download the Town of Van Horn Utility Disconnect Form.
- 2
Complete The Form
Enter your name, phone number, service address, requested cutoff date, and new mailing address if applicable.
- 3
Sign And Date
The account holder signs and dates the form.
- 4
Submit To The Town
The form lists the Town of Van Horn at 1801 W. Broadway, P.O. Box S17, Van Horn, Texas 79855.
Frequently asked questions
- What does the Utility Disconnect Form request?
- It lets an account holder request a utility cutoff date for service at a listed address and provide a new mailing address if applicable.
- Who can use the Utility Disconnect Form?
- A Town of Van Horn utility account holder who no longer requires services at the listed address can use the form to request a cutoff.
- Do I need a notary for the Utility Disconnect Form?
- No. The form is signed without a notary; the account holder signs and dates it.
- How do I submit the Utility Disconnect Form?
- The form lists the Town of Van Horn at 1801 W. Broadway, P.O. Box S17, Van Horn, Texas 79855, but does not specify a submission method.