Rock Island, WA · Douglas County
Request to Turn Water On or Shut Off (Existing Account)
Existing account holders use this form to request that water service be turned on, left on, or shut off at a meter address.
What this form is
This form lets a person request that water service for an existing account be turned on, left on, or shut off on a specified effective date. It asks for the requester’s name, account name, meter and billing addresses, phone number, service request, and signature and date. City staff sections include meter reading and account and billing dates.
Who needs it
A person requesting a water service change for an existing account in Rock Island should complete this form.
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 request has no notary block; the account requester simply signs and dates the form.
How to submit this form
- 1
Download The Form
Download the Request to Turn Water On or Shut Off (Existing Account) form.
- 2
Complete The Request
Provide the requester and account details, addresses, phone number, requested service change, and effective date.
- 3
Sign And Date
Sign and date the request. The form does not list required attachments.
- 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
- Do I need a notary for the water service request?
- No. This form has no notary block; the account requester signs and dates it.
- How do I submit the water service request?
- Submit it to the city department named on the form; check the city website for current contact details.
- What water service changes can I request?
- For an existing account, the form provides options to turn water on, leave it on, or shut it off, with an effective date.
- What information does the form ask for?
- It asks for the person making the request, name on the account, meter and billing addresses, phone number, service request, effective date, signature, and date.
Need something notarized?
This Request to Turn Water On or Shut Off (Existing Account) doesn’t need a notary — but if you have another Rock Island form that does, a commissioned online notary can help.