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Service Disconnect
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Last day I am responsible for purchasing electricity.
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Did you work with a Realtor?
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Realtor Phone Number
Do you know the name of the new occupant?
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Name of New Occupant
Phone Number of New Occupant
Signature
By signing below, I acknowledge that I am planning to move out of my current residence, thus transferring responsibility for electric service, on the "Last Day of Occupancy" as stated above.
First Name of Signee
Last Name of Signee