Closing a Utility Account Application

2. First Name

3. Last Name

5. Service Address

   The physical location of the property needing utility services.

6. Utility Account Number

   This information is located on the top portion of your bill.

8. Email Address

9. Phone Number

11. Are you a tenant or the property owner?:

    1. Tenant
    2. Property Owner

12. If you are the property owner, please indicate if the property will be sold or rented to a tenant:

14. Date you would like utility services ended

15. How would you like to receive your final bill?:

    1. Regular Mail
    2. Email

17. If you selected 'regular mail' please enter the mailing address for your final bill:

19. If you selected 'email' please enter the email address for your final bill:

21. FOIP
    This personal information is being collected for purpose of administering a customer account database, and should you select to participate, for the electronic billing system and pre-authorized payment plan option with the City of Chestermere, and as such is deemed to be an activity of the City of Chestermere. The personal information is collected under the authority of Section 33(1)c of the Freedom of Information and Protection of Privacy Act, and will be used only for the purpose identified. If you have any questions or concerns about the collection or use of information you may contact the FOIP Coordinator at 105 Marina Road, Chestermere, AB T1X 1V7 or call (403) 207-7050.

    This personal information is being collected for purpose of administering a customer account database, and should you select to participate, for the electronic billing system and pre-authorized payment plan option with the City of Chestermere, and as such is deemed to be an activity of the City of Chestermere. The personal information is collected under the authority of Section 33(1)c of the Freedom of Information and Protection of Privacy Act, and will be used only for the purpose identified. If you have any questions or concerns about the collection or use of information you may contact the FOIP Coordinator at 105 Marina Road, Chestermere, AB T1X 1V7 or call (403) 207-7050.

Leave This Blank:


23. 1. Receive an email copy of this form.
24. Email address

    This field is not part of the form submission.

25. Submit

* indicates a required field