Request to cancel utility service You must have JavaScript enabled to use this form. Required fields are marked with an asterisk (*) Account Holder Information Company Name (Commercial account only) First Name & initial This field is required. Please enter the your first and last name as it appears on your Halifax Water bill. Last Name This field is required. Name of the Submitter of the form, if different than above First Last Name of the submitter of this form, if it's different than the name above. Phone Number This field is required. Alternate Phone Number Email Email This field is required. Confirm email This field is required. Service (Civic) Address Civic Number This field is required. Unit / Apartment Street Name and Type This field is required. City / Community This field is required. Province This field is required. - Select -British ColumbiaAlbertaYukonSaskatchewanNorthwest TerritoriesManitobaNunavutOntarioQuebecNew BrunswickNova ScotiaPrince Edward IslandNewfoundland and Labrador Postal Code This field is required. Forwarding Address: Civic Number Unit / Apartment Street Name and Type City / Community Province - None -British ColumbiaAlbertaYukonSaskatchewanNorthwest TerritoriesManitobaNunavutOntarioQuebecNew BrunswickNova ScotiaPrince Edward IslandNewfoundland and Labrador Postal Code Cancellation Date Preferred date for cancellation of service This field is required. Access and Privacy I Agree to Submit This field is required. In accordance with Section 485 of the Municipal Government Act (MGA) [PDF], the personal information collected on this form will only be used by Halifax Water staff for purposes relating to the provision of water, wastewater, and/or stormwater services. If you have any questions about the collection and use of this personal information, please contact Customer Care at 902-420-9287 or CustomerCare@halifaxwater.ca. CAPTCHA This question is for testing whether or not you are a human visitor and to prevent automated spam submissions. Leave this field blank
