Account Transfer

ACCOUNT TRANSFER INFORMATION

SERVICE # ________________ BOOK # _________________

	SELLER'S INFORMATION		BUYERS INFORMATION
DATE RECV'D	____________________	CLOSING DATE	____________________	READ DATE _______
NAME	____________________	NAME	____________________	WATER ___________
PROPERTY	____________________	ADDRESS	____________________	PAST DUE ________
AGENT	____________________		____________________	SEASONAL _______
AGENCY	____________________	PHONE #	____________________	TRANS. FEE 25.00__
PHONE #	____________________		____________________
FAX #	____________________		____________________	TOTAL DUE _______

DATE FAXED_________________________

FAXED TO ___________________________

INITIALS ____________________________

DATE METER READING

______________________________

______________________________

TOTAL GALLONS ______________