UTILITIES TRANSFER REQUEST FORM

Please complete all information to request a final reading for the property.

Date of Transfer *

Service Address being transferred *

Parcel Number

Name of Seller *

Address of Seller if other than service address *

Buyer's Name *

Buyer's Address if not residing

Buyer's Phone Number *

Buyer's Email *

Settlement Company Name *

Settlement Company Address *

Settlement Company Phone Number *

Settlement Company Email *

This portion completed by Town of Boonsboro

Account Number

Location Number

Meter Number

Previous Read

Current Read _______________________________________

* - denotes required field