2. City of Wayne
   Final Water Read Request

   **For transfer of ownership only**

4. Requestor Name:*
6. Requestor Phone Number:*
8. Property Address:*
10. Previous Owner's Name:
12. Previous Owner's Phone Number:

16. For Final Water Reading, please fill out the information below

18. Date of Closing:*
20. Is the property vacant?

    1. Yes

    1. No

    1. Unknown
22. When did the previous owner/renter vacate the property?

26. New Owner Information

28. First Name*
29. Last Name*
31. Address
33. City
34. State
35. Zip Code
37. Phone Number
38. Email Address
40. Move in date:

44. Choose Method of Delivery Below

46. Method of Delivery

    1. MAIL
    2. E-MAIL
    3. PICKUP
48. Name
49. Email Address
51. Address
53. City
54. State
55. Zip Code
57. Phone Number

59. PLEASE ALLOW 48 HOURS FOR PROCESSING OF FINAL WATER BILL

Leave This Blank:


61. 1. Receive an email copy of this form.
62. Email address

    This field is not part of the form submission.

63. Submit

* indicates a required field