Cowlitz County Public Utility District » New Services » Start, Stop or Transfer Service » Moving? Transfer Your Service

Moving? Transfer Your Service

Name*
First Middle Last
Phone*
Account Number*
Email Address*
Current Service Address*
Street Address Address Line 2 City State ZIP Code
Move Out Date*
MM slash DD slash YYYY
New Service Address*
Street Address Address Line 2 City State ZIP Code
Move In Date*
MM slash DD slash YYYY
Does any account information need to be updated?*
- Yes
- No
For example, phone number, mailing address, adults living in the home, etc.
Primary Resident
Name
First Middle Last
Primary Phone Number*
Other Phone Number
Email*
Spouse
Name
First Middle Last
Primary Phone Number
Other Phone Number
Email
Other Adult 1
Name
First Middle Last
Primary Phone Number
Other Phone Number
Email
Other Adult 2
Name
First Middle Last
Primary Phone Number
Other Phone Number
Email
Please call Customer Service at (360) 423-2210 if there are more than four adults moving into this location.
Mailing Address
Send Mail To
Street Address Address Line 2 City State ZIP Code
Other Information
Owner or Renter*
- Own
- Buying
- Renting
Landlord Name*
Do you consent to signing this document electronically?*
- Yes
Full Name (Digital Signature)*
Date*
MM slash DD slash YYYY

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