Residential Transfer Service

Residential Transfer Application
Date*

MonthDayYear
Date
Account Number
Name*

First NameLast Name
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Email*
example@example.com
Deposit can be transferred only if a new service is established within(14) business days of discountinued services.

If more than two weeks, please complete a Disconnect and New Residential Application

The City of Melissa service request for same day

Mon- Thurs before 2:00 pm

Friday before 10:00 am

Any request after the hours stated will be processed on the following business day
Please sign me up for E-Billing. I understand that I will NOT receive a paper statement.Opt in to the Melissa Minute

Residential Transfer Application