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2. This form provides the information we need to perform a final utility meter reading. If you have questions, please contact City Hall at 616-527-4170.

6. Dates

8. Today's Date*
   Today's Date
9. Date of Final Meter Read*
   Date of Final Meter Read

13. Contact Information

15. Requestor Name*
17. Service Location Address*
19. City*
20. State*
21. Zip Code*
23. Home Phone*
24. Alternate Phone
26. Email Address*

30. Final Bill Mailing

32. Bill to Name / Business*
34. Mailing Street Address*
36. City*
37. State*
38. Zip Code*
40. New Tenant Name

    (If known)

Leave This Blank:


42. 1. Receive an email copy of this form.
43. Email address

    This field is not part of the form submission.

44. Submit

* indicates a required field