Fillable City of Hickory, North Carolina Appendix 2 Application (City of Hickory)

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City of Hickory, North Carolina Appendix 2 Application (City of Hickory)

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City of Hickory, North Carolina
Utility Billing Policy and Procedures
Appendix 2 – Application for Transfer or Termination of Service
Customer Name: ____________________________________________________
Service Address: ____________________________________________________
Home Phone # __________________Daytime Phone # ________________
Account #___________-____________
I hereby wish to:
____ Terminate service (Water, Sewer, & Solid Waste Fee Services)
Date Utility Service to be discontinued: ___________________________
• Monday – Friday
• The City provides next day service–same day services are not available
• Must be a future date-terminations will not be backdated
Address to mail final bill and/or deposit
refund as applicable: ____________________________
____________________________
Note: Your Utility deposit will be applied against your final bill and you will receive a
refund or bill for the difference.
_____ Transfer service to another location (Water, Sewer, & Solid Waste Fee Services)
Date OLD service to be discontinued: ___________________________
• Monday – Friday
• The City provides next day service-same day services are not available
• Termination must be a future date-terminations will not be backdated
NEW Utility service location: ____________________________
Date NEW Utility service effective: ____________________________
• Monday – Friday
• The City provides next day service-same day services are not available
New billing address: _____________________________
_____________________________
I hereby certify that the above information is true and accurate.
_______________________________ ________________________
Signature Date
_______________________________
Printed Name
COLLECTIONS FAX (828) 431-4593 Employees Initials_________
Date Received_____________
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City of Hickory, North Carolina Appendix 2 Application (City of Hickory)

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Completed 23 January 2021

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