Do I need a notary for the Water Service Disconnect/Transfer Form?

No. This form is signed and dated without a notary, and it lists no notarized or sworn attachment or related step.

How do I submit the Water Service Disconnect/Transfer Form?

Send it to the Utility Billing Department by email, fax, or mail using the contact information on the form. The customer is responsible for verifying that the completed form was received.

What must I include with a service request?

The form requires a copy of the driver's license for all service requests. Complete the applicable disconnection or transfer section and sign it.

Can I use this form to transfer service to another address?

Yes. The transfer section is for customers moving from one Midlothian address to another. The connection and disconnection dates can be no more than 10 calendar days apart.

Midlothian, TX · Ellis County

No notary required

Water Service Disconnect/Transfer Form

Customers use this form to request water service disconnection or transfer service between two Midlothian addresses.

What this form is

Use this form to request water service disconnection or transfer service when moving from one Midlothian address to another. It asks for customer contact information, service and forwarding or mailing addresses, requested dates, and signatures; a copy of the driver’s license is required for all service requests. The form also notes service timing and possible bills after disconnection.

Who needs it

Midlothian water customers who are disconnecting service or transferring it between two Midlothian addresses should complete this form.

How to submit it

Send the completed form to the Utility Billing Department by email at [email protected], fax at 972-775-7160, or mail to City of Midlothian, 215 N. 8th St, Midlothian, TX 76065; verify it was received.

About notarization

This form 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 Water Service Disconnect/Transfer Form.
2
Complete The Applicable Section
Fill out the disconnection section or, when moving between Midlothian addresses, the transfer section. Provide the requested dates and sign.
3
Gather The Required Attachment
Include a copy of your driver's license, which the form requires for all service requests.
4
Submit To Utility Billing
Email, fax, or mail the form to the Utility Billing Department using the contact information provided; verify that it was received.

Frequently asked questions

Do I need a notary for the Water Service Disconnect/Transfer Form?: No. This form is signed and dated without a notary, and it lists no notarized or sworn attachment or related step.
How do I submit the Water Service Disconnect/Transfer Form?: Send it to the Utility Billing Department by email, fax, or mail using the contact information on the form. The customer is responsible for verifying that the completed form was received.
What must I include with a service request?: The form requires a copy of the driver's license for all service requests. Complete the applicable disconnection or transfer section and sign it.
Can I use this form to transfer service to another address?: Yes. The transfer section is for customers moving from one Midlothian address to another. The connection and disconnection dates can be no more than 10 calendar days apart.

Need something notarized?

This Water Service Disconnect/Transfer Form doesn’t need a notary — but Texas residents can notarize other documents online with a commissioned online notary.