Form

REQUEST A SERVICE

Start or Discontinue Water & Sewer Service
ub@slocity.org

(805) 781-7133

PLEASE NOTE: Discontinuing service will turn water off to the property as early as 7:30 AM the morning of the requested service day.
Service Address *
Account Holder's Name *

First Name Last Name
Care of

Mailing Address *

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Account Holder's Social Security or Tax ID Number *
Phone Number *

- Area Code Phone Number
Work Phone Number

- Area Code Phone Number
E-mail *
I would like to: *

Start Service Stop Service
Date to Start or Stop Service *

- Month - Day Year
Notes
To confirm your request, please enter the word in the grid to the right. *
Should be Empty: