Closure of Account Form

By signing this form, I am requesting that Provo Water Company (PWC) discontinue water service to the above mentioned service address and close my account. I am also acknowledging the following: (1): PWC will prepare a final bill and forward a final account statement to my forwarding address. (2): PWC will apply any credits that I have on this account to this final bill. If the final statement has a credit balance or there is a deposit on this account, PWC will have a refund cheque available for pick up within 10 days. (3): If there is a balance due on the final account statement, the entire balance is due and payable upon receipt and delinquent after 14 days from the date on the statement. (4): PWC has the right to forward your account to the Collections Department to recover the outstanding balance and any associated fees.