Forfeit Tap Authorization Form
Service Address of the tap being forfeited:
Blue Ridge Rural Water Account Number:
By forfeiting a tap water service is no longer wanted at this location. This is NOT transfering service to new owner.
Name on the Blue Ridge Rural Water account
First and Last Name
Please attach a scanned copy of a photo ID of the account holder on record with Blue Ridge Rural Water or the individual who have legal authority to act on behalf of the account holder.
I understand that I am no longer need water service at this location by forfeiting the service at this location listed above. If I wish to have water service in the future, I will have to pay previous monthly bills in addition to the account set-up, meter, and tap fees at that time.
Please click submit and you will be redirected to Blue Ridge Rural Water Company's website.
A copy of the completed forfeit form will be sent to your email provided for your records.
Thank you for your time.