Summer Temporary Disconnect Service Form 2010-11-12-2025

1. Click ‘Get Form’ to open the Summer Temporary Disconnect Service Form in the editor.
2. Begin by entering your LCU Account Number in the designated field at the top of the form.
3. Next, fill in the Name on Account section with the name associated with your utility account.
4. Provide your Driver's License Number to verify your identity.
5. In the Service Address fields, enter the complete address where service is currently provided.
6. Specify your desired Disconnect Date and Reconnect Date. If unsure about the reconnect date, you may leave it blank for now.
7. Fill in a temporary phone number and mailing address if applicable, ensuring we can reach you during this period.
8. Finally, authorize the service request by signing and printing your name in the designated areas at the bottom of the form.

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