Forms • Libertyville • CivicEngage

Water & Sewer-Terminate Service Form

Leave This Blank:

Closing Date or Date Lease Terminates? (mm/dd/yy)*

Current Last Name on Water Account*

First Name*

Account Number

Service Address*

Address to Send Final Bill to:*

Are You the Owner or Renter of This Location*

Owner

Renter

* indicates required fields.