Move In/Move Out Form (Homeowners Only)
City of Port Washington Water & Sewer Utility
Name
*
First Name
Last Name
Name (If Needed)
First Name
Last Name
Name (If Needed)
First Name
Last Name
Address (where you are moving FROM)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
-
Area Code
Phone Number
Account Number
Water/Sewer Account Number (ex: 0-00000000-00)
Closing Date
-
Month
-
Day
Year
Date Picker Icon
Is The Pending Water Bill at the Residence being Prorated (Check With Your Title Company)
Yes
No
I Don't Know
Name of Person Buying Home
First Name
Last Name
Name of Person Buying Home (If Needed)
First Name
Last Name
Name of Person Buying Home (If Needed)
First Name
Last Name
House Not Sold (Is Vacant)
Yes
No
Forwarding Address (where you are moving TO)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Additional Information
Address (where you moving TO)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
-
Area Code
Phone Number
Closing Date
-
Month
-
Day
Year
Date Picker Icon
Is The Pending Water Bill at the Residence being Prorated (Check With Your Title Company)
Yes
No
I Don't Know
Name of Person You Bought Home From
First Name
Last Name
Name of Person You Bought Home From (If Needed)
First Name
Last Name
Name of Person You Bought Home From (If Needed)
First Name
Last Name
Additional Information
Enter the message as it's shown
*
Submit
Should be Empty: