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Change of Mailing Address

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CHANGE OF MAILING ADDRESS
CUSTOMER NAME*
ACCOUNT NUMBER*
Effective Date*
Effective Date
EMAIL ADDRESS
CURRENT MAILING ADDRESS:
Street Address*
City, State, Zip*
NEW MAILING ADDRESS:
New Mailing Street Address*
New City, State, Zip*
NEW/CURRENT PHONE NUMBER*
PLEASE NOTE:
The Post Office will not forward your water bill. You must change your address with the City of West Melbourne Utilities Department.
By signing below, I understand that anytime my mailing address changes, I need to notify the Utilities Department immediately.
Signature*
Type name
Today's Date*
Today's Date