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Transfer of Account

2. Date:*
   Date:

4. Account #:*

6. Service Location:*

8. I, the undersigned do hereby agree to transfer all rights, deposits, and outstanding balances on fill with the City of Schertz for the above referenced account to:

   I, the undersigned do hereby agree to transfer all rights, deposits, and outstanding balances on fill with the City of Schertz for the above referenced account to:

11. with to provision that he/she appears and signs the agreement to accept this transfer. The transfer must be performed no later than:

    with to provision that he/she appears and signs the agreement to accept this transfer. The transfer must be performed no later than:

14. or this account is to be terminated.

    or this account is to be terminated.

18. Current Customer:*

20. Electronic Signature*

21. Date Signed*
    Date Signed

23. Driver's License Number

27. New Customer *

29. Electronic Signature*

30. Date Signed*
    Date Signed

32. Driver's License Number

Leave This Blank:


34. 1. Receive an email copy of this form.
35. Email address

    This field is not part of the form submission.

36. Submit

* indicates a required field