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Application for Disconnection of Utilities

  1. Account Type:*

  2. Discontinue Services For:*

  3. By checking the "I agree" box below, you agree and acknowledge that:
    1) Your application will not be signed in the sense of a traditional paper document.
    2) By signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature.
    3) You may still be required to provide a traditional signature at a later date.*

  4. The personal information on this form is collected under the authority of the Municipal Government Act and is protected under the provisions of the Freedom of Information and Protection of Privacy (FOIP) Act. If you have any questions about the collection, use and protection of this information, please contact Red Deer County at 403.350.2150.

  5. Leave This Blank:

  6. This field is not part of the form submission.