Account Information Form

ACCT #
**BALANCE** 
GOOD TO:
VERIFY 1 VERIFY 2
Property Type
$
Quarterly Facility Charge
SEWER USE 
Town Owned Grinder Pump
OTHER CHARGES
Secondary Meter
NOTES:
If there is a sewer deduct meter, the deductions will end 
with the seller; the new owner can continue if an 
application is filled out at our office.
(1) Name of Person and Company requesting information:
It is important to note that we bill in arrears.  Therefore, a final water meter reading from the City of New London is required to calculate the final bill.
Contact New London Veolia Water at 860-447-5222 to schedule a final water meter reading.
(5) Property Location:
(8) Name of Prospective Owners
(6) Today's Date:
(2) Phone Number :
(4) Email Address:
When Property sells, this grinder pump becomes 
the responsibility of the new owner
**IMPORTANT**PLEASE ALLOW 48 HOURS FOR INFORMATION TO BE COMPLETED AND EMAILED BACK TO YOU**
INSTRUCTIONS: Please fill in the information for items 1 through 8 and email  to  wuc@waterfordct.org
WATERFORD UTILITY COMMISSION ACCOUNT INFORMATION FORM
We are happy to help with calculations!! 
 Please submit to us the final New London water bill and we will send you a completed worksheet of the final sewer cost owed by the seller. 
** This is not the final amount owed by the seller - just the amount owed as of the last water meter read date which was _____/_____/_____ **
The Utility Commission bills quarterly. 
(7) Current Owner:
(3) Date of Closing: