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Residential Transfer of Service Request
Residential Account Transfer Form
"
*
" indicates required fields
Please indicate whether you are the current or new account owner
*
I AM THE CURRENT OWNER
I AM THE NEW OWNER
Your Name
*
Account Number
*
Name of The Person You Are Transferring This Account To
*
Signature
*
Date
*
MM slash DD slash YYYY
Please Note: Transfer of account ownership will not take place until both parties have completed and signed their respective forms. Any automatic payment information and web account access will be removed with this transfer of account ownership.
Last 4 Digits of Your Social Security Number
*
Driver's License or State ID Number
*
Your Phone Number
*
Email Address
*
How Would You Like Your Listing to Appear in the Phonebook? (If applicable)
Billing Information
Billing Street Address
*
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Signature
*
Date
*
MM slash DD slash YYYY
Please Note: Transfer of account ownership will not take place until both parties have completed and signed their respective forms. Automatic payment information and web account access will be deactivated on this account. If you would like to activate either of those options, please contact our Customer Service Team at 715-421-8111 (Wisconsin Rapids area) or 920-596-2535 (Manawa area).