• If there is a deposit on file, the deposit will be applied to the Final bill. Any credit still left on the account will be sent in the form of a check to the forwarding address provided.
• Email or fax this form back to: firstname.lastname@example.org / 210-619-1139 FAX
• Submitting this form does not guarantee services are disconnected until you receive a confirmation of
disconnection back via email. If you need a same day disconnection please contact our office at 210-619-1100.
By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.
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