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Final Water Reading Request Form

2. Domestic Reading

3. Domestic ID #

4. Lawn Reading

5. Lawn ID #

7. Fire Meter

8. Fire ID #

9. Date Completed
   Date Completed

10. Completed By
    -- Select One --Carole SelittoJessica IcolariToni-Ann IcolariNathan Kiracofe

12. Billed

    Select if Billed by Finance

    1. Billed
13. Comments

17. Final Reading Address:*

    (Street Address Only, Town and Zip Code not required)

18. Rental Property*

    1. No

    1. Yes

    Check if Rental Property

20. Name (Current Owner or Landlord):*

21. Name (Tenant):*

22. Owner/Landlord Address

    If different than final reading address

24. Block (if known)

25. Lot (if known)

26. Account # (if known):

27. Phone Number:*

29. Email:

30. Forwarding Address for Final Bill*

31. Fax Number for Final Bill:

35. Final Reading Date & New Owner/Tenant Information

    (final reading will not be done without new name)

    (final reading will not be done without new name)

37. Reading Request Date*
    Reading Request Date

    (must be before closing date)

38. Closing Date:*
    Closing Date:

39. Own or Tenant*

    1. New Owner

    1. New Tenant

41. New Account Holder Name:*

42. Phone Number:

43. Email:

45. PLEASE SUBMIT THE FORM AT LEAST 24 HOURS IN ADVANCE TO SCHEDULE A FINAL WATER READING. SAME DAY FINAL READINGS CANNOT BE PERFORMED.

Leave This Blank:


46. 1. Receive an email copy of this form.
47. Email address

    This field is not part of the form submission.

48. Submit Submit and Print

* indicates a required field