Start/Stop Service

Start Service
To begin service, please print and fill out this form. 
Once filled out, please bring a completed form along with proof of lease/ownership and a photo ID to Bethany City Hall, located at 6700 NW 36th St, between 8a - 5p Monday - Friday. 
Stop Service

Date to End Service:
mm/dd/yyyy
Name:

Address to Disconnect:

Forwarding Mailing Address:

Phone:

Email:

Account Number: 
Account Number
Date Requested: 
Today's date