E-SERVICES

Online Self-Service
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E-SERVICES

SCHEDULE A SERVICE DISCONNECT

Please fill out the following form to Schedule A Service Disconnection. Your request will be processed within 48 hours and an e-mail confirmation will be sent to you to confirm that your request has been processed.

*Customer Name

*Email Address

*Service Address

*Date to Disconnect :

*Daytime Phone Number

*Forwarding Address: Apt

*City *State *Zip

*For verification purposes, you must enter the last 4 digits of the
social security number that Daphne Utilities has on file for your
account: