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Disconnect & Final Bill Request For - Property Managers/Landlords

Please correct the field(s) marked in red below:

  • Requests for disconnect and final bill must be received at least two business days prior to the requested date per City Ordinance. In order to disconnect service in two business days, applications must be received by 12:00 pm Pacific time Monday through Friday (excluding holidays).

  • Service can be disconnected on normal business days: Monday – Friday, 8 a.m. to 5 p.m. (excluding weekends/holidays).

  • Customers will receive notification from the City of Vacaville indicating whether the application has been accepted or whether the Customer Service Division must be contacted to complete the application process.

  • Approved customers will receive a final bill based on the meter reading from the disconnect request date. Please allow 1-2 weeks from the disconnect request date for the final bill to be issued.

  • Once accepted customers will receive a confirmation number when their disconnect request has been submitted to field staff. This number serves as proof that you have requested to have your service disconnected.

  • Please provide a forwarding address to mail the final bill.

* = indicates required field

1
Date of Service Disconnection
(Note: Minimum two business days' notice. In order to disconnect in two business days applications must be received by 12 p.m. Pacific Time). 
 *
2
Service Location
 *
Service Location
3
Company or Landlord Information
 *
Company or Landlord Information
Note: In order to prevent and mitigate ID theft and in compliance with the Fact Act of 2003, it is essential that every written communication, including emails, received by the Utility Billing Division contains the last four digits of the account holder’s social security number or the tax identification number. In the event that a staff member within the Utility Billing Division needs to call to obtain additional information, such as the full social security number to validate identity, you must also provide a daytime telephone number.
4

Mailing Address for Final Bill

 *
5
Requesting Business Representative 
(Note: The application must completed by the business owner or authorized representative for the business. The City of Vacaville does not allow another party to end financial responsibility under another entities’ name.)
 *
Requesting Business Representative (Note: The application must completed by the business owner or authorized representative for the business. The City of Vacaville does not allow another party to end financial responsibility under another entities’ name.)
6
Confirmation of Request 
* The City of Vacaville will confirm account request for disconnect by email. Please enter the email address below to ensure delivery.
 *
Release of Liability
The City of Vacaville, its officers, officials, employees, and representatives are not liable or responsible for any injury or damage that may result from the discontinuance of water service.
7
By clicking here, I acknowledge that I have read and understand the release of liability listed above. I understand that if I do not click yes, the requested service will not be provided to me.
By clicking here, I acknowledge that I have read and understand the release of liability listed above. I understand that if I do not click yes, the requested service will not be provided to me.

Acknowledgements

  • Closing bill: I acknowledge that I am liable for all fees associated with water and sewer service for the location above through the date the account is closed.

  • Transfer of Balance: I acknowledge that any delinquent balance from my account at this location can be transferred to any active account in my name and the service at that location will be subject to termination if not paid within 15 days of notification of said transference.

  • Collections and Recovery Costs: I acknowledge that any delinquent balance from my account at this location can be sent to the Franchise Tax Board (FTB) for interagency intercept collections and/or a collection agency. My account would be charged a collection recovery fee if it is referred to collections.

  • The Franchise Tax Board operates an intercept program in conjunction with the State Controller’s Office, collecting delinquent liabilities individuals owe to state and local agencies and colleges. FTB intercepts tax refunds, unclaimed property (UPD) claims and lottery winnings owed to individuals. FTB redirects these funds to pay the individual’s debts to the agencies/colleges (California Government Code Sections 12419.2, 12419.7, 12419.8, 12419.9, 12419.10, 12419.11 and 12419.12).
8
By clicking here, I acknowledge that I have read and understand the acknowledgements listed above. I understand that if I do not click yes, the requested service will not be provided to me.
By clicking here, I acknowledge that I have read and understand the acknowledgements listed above. I understand that if I do not click yes, the requested service will not be provided to me.

9
Signature
10
Today's Date
 *

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