Bancroft-Clover Water & Sanitation District -
For Customers
Property Address
City
State/Zip
Closing Date
Name Of Tenant Vacating
Tenant Phone Number
Forwarding Address
Name of New Tenant
Phone Number
Email
Mailing Address (if different from above)
Who would you like the final bill sent to?
Name
Mailing Address
City
State/Zip
***FOR BANCROFT-CLOVER USE ONLY:
ACCOUNT #
METER LOCATION
FINAL METER READING
MXU #
METER SIZE
APPOINTMENT TIME TO READ REMOTE
ENDING METER READING
INTERIM METER READING
SERVICE DATES FOR ACCOUNTS RECEIVABLE
NOTES