Cancel Utility Service Account Online Form

This online form provides the City of Elko New Market the information needed to update our utility billing system when a resident is requesting to remove their name from the utility billing account.

Service Address:
Please provide the service address below by entering the house number and locating the street name of the property in the pull-down list.

House Number *

Street Name *

Zip Code *

Are you a Renter or Owner *

Please enter the date of closing:

Date of Closing (if applicable)

Please enter your move-out date:

Move Out Date / Final Meter Read Date *

Is this a forclosure? * Yes
No

Foreclosure Disclaimer:
If this property is going through the foreclosure process, the City of Elko New Market will be unable to remove your information from the utility billing account until the City receives documentation from the new owner or representative of the new owner (bank, realtor, title agency, etc.) requesting service to be transferred into their name.

Requester Contact Information:
Please provide your contact information below.

Full Name *

Phone Number *

Cell Phone Number

Email Address

Property Owner Information:
If this property is being vacated by a renter, please provide property owner information below.

Full Name

Street Address

City, State, Zip

Forwarding Address:
Please provide your forwarding address below. Your final utility bill will be mailed to this address.

Mailing Address

City, State, Zip

Additional Comments:
Please provide any additional information or comments below.

Additional Comments

I Accept * By checking this box, I state that I have authority to direct the City to add or modify information regarding the above service address.

* - denotes required field