PERMANENT SERVICE
DISCONNECT/REMOVE FORM
DATE SERVICE REQUIRED TO BE REMOVED:
Note: 10 days advance notification of the actual service removal date is required.
REQUESTED BY:
TYPE OF REMOVAL BEING REQUESTED
Remove Hydro Service
Remove Water Service
Vaughan accounts will be charged a $46.00 removal fee
Markham accounts will be charged a $136.00 removal fee
(5/8"x3/4" or 3/4") or $180 removal fee (1")
Note: If applicable, an appointment needs to be scheduled to have water meter removed.
ACCOUNT INFORMATION
Account Number:
Electric Meter #
Name on Account:
Water Meter #
Service Address:
Business Phone #
Alternate Phone #
Fax Number:
Retailer Account ?
FINAL BILL INFORMATION
Street:
Town:
Business Phone #
Attention:
Prov:
Postal Code:
Alternate Phone #
I acknowledge and agree to completely release PowerStream of any liability, damages, claims or losses
that may occur as a result of the permanent removal/disconnection of the service to the above noted
property.
DIGITALLY SIGNED:
DATE:
Customer Service
Vaughan Vicinity 905-417-6900 ~ Barrie Vicinity 705-722-7222 ~ All Other Areas 1-877-963-6900 ~ 8:00 a.m. – 4:30 p.m. Monday to Friday