Stop or Transfer Municipal Services

Please fill out and submit the form below to stop or transfer municipal services. For further information or questions, please email our Accounting Clerk Emily Light at elight@adeliowa.org.

Name*
First Last
Name Change on Account*
First Last
Date of Request*
MM slash DD slash YYYY
Phone Number*
Alternate Number*
Date of Service Change*
MM slash DD slash YYYY
Address of New Service*
Street Address Address Line 2 City State ZIP Code
Address for Final Read*
Street Address Address Line 2 City State ZIP Code
Which best describes the address you are suspending service from?*
- Purchasing
- Renting
- Sold
Landlord*
First Last
Previous Owner*
First Last
New Owner*
First Last
Moving From*
Street Address Address Line 2 City State ZIP Code
Address to Send Final Bill*
Street Address Address Line 2 City State ZIP Code
Phone
This field is for validation purposes and should be left unchanged.