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TERMINATION OF UTILITY SERVICES
This form has been modified since it was saved. Please review all fields before submitting.
Please complete the online form below to Terminate Utillity Services
Date you wish to Terminate Services:
*
Property Address:
*
City
*
State
*
Zip
*
Primary Applicant's Name:
*
Forwarding Mailing Address
*
City
*
State
*
Zip
*
Home Phone Number
*
Cell Phone Number
Employer
*
Work Phone
*
Email Address
Driver's License Number/State
*
Secondary Applicant's Name
Roommate
Roommate
Spouse
Spouse
Mailing Address
State
City
Zip
Home Phone
Cell Phone
Employer
Work Phone
Email Address
Driver's License/State
I agree and acknowledge by clicking the box below that I am disconnecting my utility service with Kittitas PUD. I understand that I am fully responsible for any charges incurred at the location listed above and agree to have my current account paid in full at time of termination. Final balance paid within 30 days of termination or I will be sent to collections.
*
I Agree and Acknowledge the above statement.
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