Request to cancel utility service

Required fields are marked with an asterisk (*)

Account Holder Information
Service (Civic) Address
Forwarding Address:
Cancellation Date
In submitting this form the customer acknowledges and agrees to the following conditions: The applicant agrees to take and pay for water, wastewater and stormwater service from Halifax Water in accordance with this application and to accept and pay for such services according to the rates, rules and regulations of Halifax Water.
In accordance with Section 485 of the Municipal Government Act (MGA), the personal information collected on this form will only be used by Halifax Water staff for purposes relating to the provision of water and/or wastewater/stormwater services. If you have any questions about the collection and use of this personal information, please contact Customer Service at 902.490.4820 or
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