Vacation Plan Request

Vacation Plan Request Form

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• Please complete the following form to request a change on your Hardin County Water District No. 2 account:
  • REQUEST Vacation Plan
  • REMOVE Vacation Plan
  Please complete the following form to request a change on your Hardin County Water District No. 2 account:

• Account Number*
• Customer Name*
  First Last
• Phone Number*
• Email*
• Requested Effective Date*
  MM slash DD slash YYYY
• Service Address*
  Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code
• Photo ID Upload*
  Max. file size: 50 MB.
  Please upload a state or federal photo ID.
• Is the mailing address different than the service address?*
  • Different
  • Same
• Mailing Address*
  Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code

• Accounts that are placed on Vacation Plan will not be charged the minimum monthly bill. When accounts are placed on Vacation Plan the meter is turned off and locked. Accounts may stay on Vacation Plan up to 6 months. Accounts that wish to have their services turned back on will need to be scheduled two days in advance. A $25 service fee is added when the service is turned back on.

  UNLESS ARRANGEMENTS ARE MADE IN ADVANCE, ACCOUNTS THAT ARE ON VACATION PLAN FOR OVER THE 6 MONTH ALLOWABLE PERIOD WILL BE AUTOMATICALLY CLOSED.

• Customer Consent

• Government Issued Photo ID*
  Max. file size: 50 MB.
• Signature of account holder*
  I certify that I am the account owner for the property listed above, and I hereby request the change on this account as indicated above and accept the terms of this vacation plan request.
• Date
  Month

  Day

  Year
• Email
  This field is for validation purposes and should be left unchanged.

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