Muscle Shoals Electric Board, AL - Stop Service

Name: (must match name on account) Name: (must match name on account) First Last
Email:
Phone: Phone: - ### - ### ####
Service address: Service address:
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Date service is to be disconnected: Date service is to be disconnected: / MM / DD YYYY
Mailing address (where final bill will be sent): Mailing address (where final bill will be sent):
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
State of Driver's License
Driver's License Number:
Maximum of 12 characters allowed. Currently Entered: 0 characters.
Attach driver's license:
(File limit is 3MB)
Agreement:

Agreement: I hereby certify that I am authorized to discontinue service at the above address, and that I am requesting that my services be disconnected effective on the date requested above. I understand that services may be disconnected at any time on the date requested or the next business day without further notice, and that MSEB will not be responsible for any damages, liability, etc that may result from disconnection of utility services. I understand that I am still responsible for any outstanding balances owed and that once deposits are applied, a final bill or refund check will be sent to the mailing address provided above.
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