Discontinue Service Form

Notice To Discontinue Service Form

Disconnect service is requested for:

Town:	Reading Lynnfield North Reading Wilmington
Meter/Service address:

Customer name:
Is this property being sold? Yes No

Service disconnect date:
This is the date we will use to terminate your account with RMLD.

Contact person for this account:
Day phone number*:
*This is the number we will use to call you today, if we have any questions.

Forwarding address for the final bill:
Street:
City:
State:
Zip:

Is an estimated bill needed for passing of papers? Yes No If yes:
When would you like to receive the estimated bill? I will pick up at RMLD, or Please fax to fax number: Attention of:

Comments: