Water Account Transfer Form

Water Service Account Transfer
Property Information
Account Service Address *

Street Address

City

Postal / Zip Code
Closing Date *

Month Day Year
Date Hour Minutes AM/PM Option
Seller Information
Seller Name *

First Name Last Name
Seller's Email
example@example.com
Seller's Attorney *

First Name Last Name
Attorney's Email *
example@example.com
Attorney's Phone *

Area Code Phone Number
The seller is responsible for a $50 closing fee that will be included with the current amount due from the seller at the time of closing. Payment for the closing fee should be paid within 7 days after the closing. Please mail checks (no cash) to the Albany Water Department, 10 N Enterprise Drive, Albany, NY 12204 *

Acknowledged
Buyer Information
Buyer's Name *

First Name Last Name
Buyer's Phone Number *

Area Code Phone Number
Buyer's E-mail *
Buyer's Mailing Address (only if the buyer does not plan to reside at the property)

Street Address

Street Address 2

City State / Province

Postal / Zip Code Country
Buyer's Attorney *

First Name Last Name
Attorney's Email *
example@example.com
Attorney's Phone *

Area Code Phone Number
Form Submitted By: *

First Name Last Name
Phone Number *

Area Code Phone Number
I certify that the information entered is correct. The correct contact information for the Buyer is required and cannot be substituted with the Attorney's contact information. If any false information is provided, the application will not be processed and will need to be resubmitted. *

Acknowledged
Suggestions if any for further improvement:
On Taxes
Total Credit to Purchaser
Current Balance Due
Official Use Only
Closing Read
Closing Read Date

Month Day Year
Date
Last Billed Read
Last Billed Read Date

Month Day Year
Date
Consumption
# of Days
Senior Discount
Service Period
Next Bill Issued

Month Day Year
Date
Route
Customer Service Rep
Should be Empty:

Water Service Account Transfer

Property Information

Seller Information

Buyer Information

Official Use Only