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2. 

3. City of Kingsford

   The Progressive City

5. Stop Utility Service Form

7. Name*
8. Email Address
10. Property Address*
12. City*
13. State*
14. Zip Code*
16. Phone Number*
18. Service End Date:*
    Service End Date:
20. Forwarding Address*
22. Forwarding City*
23. Forwarding State*
24. Forwarding Zip Code*

26. The undersigned have read and understand the conditions of this form.

28. Electronic Signature Agreement

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
30. Electronic Signature*
32. City of Kingsford

    305 S. Carpenter Avenue

    PH: (906)774-3526

    Fax: (906)774-7093

    City of Kingsford's Website

    
    

    This institution is an Equal Opportunity Provider and Employer

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34. 1. Receive an email copy of this form.
35. Email address

    This field is not part of the form submission.

36. Submit

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