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2. START or STOP services

   _{By completing this form, you are requesting service to be started or stopped at a specific address. 
   Services include water, sewer, and refuse (depending on your address).   
   If you are requesting multiple actions (stopping and starting), you must submit one form for each action.  
   Please note - fields appear as needed.}

4. Service Address*

   YORKVILLE, IL 60560

6. START or STOP service*
   -- Select One --STARTSTOP
7. Start service requested by:*
   -- Select One --BUYERTENANTLANDLORD (on behalf of tenant)LANDLORDBUILDERATTORNEY (on behalf of buyer)
8. Stop Service requested by:*
   -- Select One --SELLERTENANTLANDLORD (on behalf of tenant)LANDLORDATTORNEY (on behalf of seller)
9. Residential or Commercial
   -- Select One --ResidentialCommercial
11. MOVE DATE*
    MOVE DATE
12. CLOSING DATE*
    CLOSING DATE
13. Business Name
15. FIRST Name*
16. LAST Name*
18. Phone Number*
19. Email Address*
21. Attorney Contact Information
23. Landlord's First & Last Name OR the Property Management Name
25. Landlord's Billing Address
26. Landlord's Phone Number
27. Landlord's Email Address
29. Builder's Name
30. Builder's Phone Number
31. Builder's Email Address
33. Buyer's First Name
34. Buyer's Last Name
35. Buyer's Phone Number
36. Buyer's Email Address
38. Seller's First Name
39. Seller's Last Name
40. Seller's Phone Number
41. Seller's Email Address
43. Tenant's First Name
44. Tenant's Last Name
45. Tenant's Phone Number
46. Tenant's Email Address
48. Forwarding Address for Final Bill
49. Forwarding City & State
50. Forwarding Zip Code
52. Final Bill Needed for Closing*
    -- Select One --YESNO
53. Lawyer Contact Information (if applicable)

    Please be detailed to help us expedite the request. 

55. Is the home new construction?*
    -- Select One --YESNO
56. Refuse Tote*
    -- Select One --35 Gallon-$39.0865 Gallon-$39.08 (standard)95 Gallon-$39.50

    Rates are per billing cycle/bi-monthly

    NOTE:  If you are age 65+ you are eligible for senior discount with proof of ID.

57. Recycling Tote*
    -- Select One --65 Gallon95 Gallon
59. Additional Notes
61. Account #

    OFFICE USE ONLY

62. Meter #

    OFFICE USE ONLY

Leave This Blank:


64. 1. Receive an email copy of this form.
65. Email address

    This field is not part of the form submission.

66. Submit Submit and Print

* indicates a required field