CITY OF FOLKSTON
Water, Sewer & Garbage Account
Transfer of Service Request
Name on Acct. ________________________________________ Date ____________________
Home Phone ___________________________ Cell Phone ______________________________
ADDRESS YOU ARE DISCONNECTING
Disconnect Address _____________________________________________________________
Date of Disconnect ____________________
ADDRESS YOU ARE TRANSFERRING TO
New Service Address ____________________________________________________________
Service Start Date ______________________
New Mailing Address ____________________________________________________________
Customer Signature _____________________________________________________________
Any past due balance on your utility account must be paid prior to your services being transferred
======================================OFFICE USE ONLY========================================
DISCONNECT ACCT NO. _________________________ READING ________________________
COMPLETED BY __________________ DATE ______________________
NEW SERVICE ACCT NO. _________________________ READING ________________________
COMPLETED BY __________________ DATE ______________________
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