I give ACWWA authorization to provide the Person/Company listed below the following item(s) concerning my account (Check all that apply)
Please include the name of the person or company to be removed from the property listed above.
By Checking the box you acknowledge you are authorized to make changes to this account. The owner of the property remains ultimately liable for such charges stated in SECTION 6.4.4 of ACWWA's Rules and Regulations.
This field is not part of the form submission.
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