New Prague Utilities End Service Form

Please submit the following form if you are requesting to end Utility Services at your address.

Please note: you must be the account holder (or listed as a third party on the account) in order to submit the form.

Account Holder Name (First & Last) *

Account Number

Phone Number *

Service Address *

Date to End Service - Owned Properties- list the closing date; Rented Properties- list the last date of responsibility/lease end date *

Are you the owner, renter or builder of this property? * Owner
Renter
Builder

Forwarding Address *

Name of Person Completing this Form. This serves as your signature. *

* - denotes required field