Service Connection / Disconnection

Please use this form to notify Customer Service if you are moving
IN or OUT of the District and want to open or close your account.

Use this form only if your home is located in the 33076 or 33067 zip codes.
If your home is located in any other zip code please click here.

check one item

Please supply this information to expedite your request.

Underlined headings are required.

First Name

Last Name

Middle Initial

Street Address

Address (cont.)

City

State/Province

Zip/Postal Code

Work Phone

Home Phone

FAX

E-mail

Billing acct # no dashes needed

On what date does this change of service take place?
This date is usually the closing date.
Please choose a Monday - Friday date.

, 2008

I am closing out my account and would like my Last Bill or Refund Check
to be sent to my new address:
(Please enter forwarding address in box below.)

First Name
Last Name
Middle Initial
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Work Phone
Home Phone
FAX
E-mail
Billing acct #	no dashes needed

Service Connection / Disconnection

Please use this form to notify Customer Service if you are moving IN or OUT of the District and want to open or close your account.

NSID Revised: March 13, 2008

Please use this form to notify Customer Service if you are moving
IN or OUT of the District and want to open or close your account.

NSID
Revised: March 13, 2008