Imperial Irrigation District

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Disconnect Service

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

To disconnect service, please complete the following fields and click submit form.

Customer Name:

Contract Account:

Service Address:

Street Address

City

State

Zip

Service Disconnection Date:

Last Four Digits of Social Security Number/Federal Tax ID:

Mailing Address for Final Bill:

Street Address

City

State

Zip

Primary Contact Phone Number:

Primary Contact Phone Number:ext.

Secondary Contact Phone Number:

Secondary Contact Phone Number:ext.

Email:

Comments: (Provide details, such as, how to access the meter)

*Required Field

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Email Address

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Code:

THis is a great service.
Jon Smith, 11/05/2019

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Title 3

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Name	Title
Rachel S.	Project Manager

The

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