Artesia Stop Service Request

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Name *

First

Last

Service Location *

Forwarding Address *

First

Middle

Last

Email *

Home and Cell Phone Number

Stop Date

(if renting use move-out date)

Signature *

First

Last

Today's Date *

I authorize Elm Ridge WCID to disconnect my service according to this request.

Connect

724 Savannah Blvd.
Savannah, TX 76227
customerservice@elmridgetx.org

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