Water Service Account Transfer
Property Information
Account Service Address
*
Street Address
City
State / Province
Postal / Zip Code
Closing Date
*
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Month
-
Day
Year
Date
1
2
3
4
5
6
7
8
9
10
11
12
:
Hour
00
15
30
45
Minutes
AM
PM
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 at the closing. Please mail checks (no cash) to the Albany Water Department, 10 N Enterprise Drive, Albany, NY 12204. PLEASE DO NOT SUBMIT ATTORNEY'S NUMBERS AS THE BUYER'S NUMBER. WE WILL REJECT THE SUBMISSION AND YOU WILL HAVE TO RESUBMIT AGAIN WITH ALL THE PROPER AND ACCURATE INFORMATION THAT IS ASKED.
*
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
*
Street Address
Street Address 2
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Postal / Zip Code
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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
Email
*
example@example.com
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. THE CORRECT MAILING ADDRESS AND CONTACT PHONE NUMBER FOR THE BUYER IS REQUIRED IT SHOULD NOT BE THE SAME AS ATTORNEY
*
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
Yes
No
Service Period
Next Bill Issued
-
Month
-
Day
Year
Date
Route
Customer Service Rep
Andrea Scheely
Sabrina Mott
Diane Babbie
Tanya Beauzile
Submit
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