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2. FINAL BILL MUST BE PAID AND AFFIXED WITH OUR TRANSFER CERTIFICATE STAMP PRIOR TO CLOSING

   When canceling an account, please keep in mind that the Village needs seven (7) business days to process request. In the event a refund is due from a final bill, please be sure to include accurate forwarding and contact information. If you have any questions, please contact the Finance Water Billing Department at 630-286-5416 during our operational hours or email waterbilling@clarendonhills.us

4. Filer First Name
5. Filer Last Name
6. Relationship to Water Account Holder
8. Email Address*
9. Phone Number*
13. Closing Date/Lease End Date*
    Closing Date/Lease End Date

    Enter your closing date or lease end date. We cannot go back in time to get a final read. Please allow two business days to obtain a final read.

14. Service Address*

    Clarendon Hills, IL 60514

18. Utility Account Number

    e.g. 000-0000-00-00

19. Relationship*
    -- Select One --Tenant/RenterProperty OwnerProperty Manager
21. Water Account First Name*
22. Water Account Last Name*
24. Forwarding Address*
26. City*
27. State*
28. Zip Code*
32. Landlord Name
33. Landlord Email Address
35. Landlord Address
37. Landlord City
38. Landlord State
39. Landlord Zip Code
41. Landlord Phone Number
45. Additional Information
47. Terms of Agreement*

    1. By clicking this box, I agree to the terms and conditions as set out in this application and in the Village of Clarendon Hills Munidpal Code. That this electronic signature is the legally binding equivalent to my handwritten signature and has the same validity and meaning. I will not, at any time in the future, repudiate the meaning of my electronic signature or claim that my electronic signature is not legally binding.

49. 1. I acknowledge that this constitutes written application for termination of utility service at the address above. Further, I acknowledge that I agree to pay all charges for services rendered as a result of this request. I understand and agree that failure to pay any amount due to the Village of Clarendon Hills can result in discontinuation of services until such time as payment has been received.

51. Questions?
    Contact Water Billing at 630-286-5416.
Leave This Blank:


53. 1. Receive an email copy of this form.
54. Email address

    This field is not part of the form submission.

55. Submit

* indicates a required field