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Stop Service For My Home/Apartment/Business

  1. Name on the Account (only account holder may request to stop service)
  2. Are you selling this property?*
  3. Forwarding Address
  4. Acknowledgement

    Submittal of this application indicates agreement to allow the City of Ankeny to stop service at the above address on the date entered on this form. 

    Note: Phone number is required so we may contact you if we have questions. 

  5. Type first and last name to sign digitally.

  6. Leave This Blank:

  7. This field is not part of the form submission.