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Form

Residential Utility Account Transfer

For Residents wanting to cancel services at one location and open services at another. The new location must be owned by the account holder.

Your personal information is being collected under the authority of section 25 of the Local Authority Freedom of Information and Protection of Privacy Act. This information will only be used to administer the program/activity it was collected for. If you have any questions about the collection please contact the Office of the City Clerk at 780-875-6184 or email cityclerk@lloydminster.ca

Information for Cancellation of Services

Account Holder Type:

Account Holder Name:

Account Number:

Move Out Date:

Information for Connection of Services

Account Holder Type:

Is the property a rental?

Yes

Possession Date:

New Service Address

Postal Code

Customer Name:

Birthdate:

Phone Number:

Email:

Would you like paperless billing?

Do you want to authorize a second contact on the account?

Completed By:

City Staff

Customer

Deposit

A deposit of $250 is required for any account in a Tenant's name, before utility services will be connected and a Utility Account number will be issued. The deposit can be paid over the phone with credit card, or in person at City Hall or the Operations Building. Also, a $60 connection fee will be added to the first invoice. Please call 780-875-6184 ext 2129 to make a credit card payment.

Previous Balance

The final balance on the account being disconnected will transfer to the new account. The final balance will be payable to your new account number.