Discontinue Water Service

Service Request *
 Personal Information
First Name
Last Name
Phone Number
Mailing Address *
 Mailing Information
Mailing Address
Zip Code
By checking the box below you agree to the following terms. I agree that the information provided is accurate and that I am the individual associated with this information. I agree to submit this information to the City of Belmont in North Carolina and understand that this information will be used to stop a Utility Account under the information I provided. I understand that I will be held financially responsible for any outstanding charges associated to this Utility Account with the City of Belmont in North Carolina. *
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City of Belmont, NC