Application for Termination of Water/Sewer Service

By signing below, I authorize the termination of water and/or sewer services from the Douglasville – Douglas County Water and Sewer Authority on or about the date requested on this form, subject to limitations herein. I understand and acknowledge that I am and remain responsible for payment of all charges, fees, penalties, and other amounts incurred on this account through the effective date of termination. I further understand that termination of my water and/or sewer service will be effective within five (5) business days after the Authority receives my completed Termination of Water/Sewer Service form, and that any request for termination submitted over a weekend or on a holiday will be processed on the next business day. I agree that this request may be stored electronically and that any electronic copy of this request, including my signature, will be deemed an original, admissible, and enforceable to the same extent as a paper original.