REAL ESTATE CLOSING Form

Selling Your Property?

To assist you with compliance with the federal Consumer Financial Protection Bureau’s Closing Disclosure, this form must be completed and received by Aquarion Water Company (AWC) at least ten (10) business days prior to a property closing. AWC will not provide balance information unless a completed request for closing form is received.

For Connecticut customers the final meter reading will be estimated unless an actual reading is provided or unless there have been two or more estimates.

Upon receipt of this form, AWC will prepare and email the final water bill for the seller to the attorney's email address. (Note: the seller's account number is located in the upper right corner of the final bill and should be placed on all checks & correspondence.) The bottom portion of the final bill should be returned with the seller's payment. In the event that the closing date is changed or cancelled, please notify AWC immediately in order to avoid billing errors.

If you need assistance, please email us at closings@aquarionwater.com or call us at 203-445-7310 or 1-800-732-9678.

  Seller's Information
 
    *Date of Closing:
 /   /     (MM/DD/YYYY)  
 
    *Seller's Name:
     Seller's Account Number:
 (Example: 200......)
   
(Providing the seller's account number will expedite processing.)
 
  Property Information
 
    *Property Address 
    *City
    *State
    *Zip
 -   
    *Please indicate if property is:
Residential   Multi-family   
Commercial
   
* A $300.00 security deposit will be charged to multi-family accounts and will
   
  appear on the first bill.
    *Is Property tenant occupied:
Yes   No
 
  Property Type
 
   
 Will this building house any of the following:
 
   
 *(Please check all applicable boxes)
 
  Animal Hospital / Grooming   
  Assisted Living / Nursing Home   
  Community Health Center   
  Dialysis Center (Commercial or Residential)   
  Hair Salon / Hair School   
  Hospital
  Hotel / Inn
  Immediate Care Clinic
  Industrial Facility
  Institutional (Prison/Jail)
  Medical / Dental Office
  Medical Laboratory
  Municipal Building
  Restaurant
  School / Day Care
  Sewage Plant / Pump Station
  Surgical Center
  University
  Water Treatments Facility
  Youth Camp
  None Of The Above
 
  Attorney Information
 
    *Last Name
    *First Name
    *Phone
 -   -   Ext.   
    *Email for Final Bill
(We will never disclose your email address)
 
  Buyer's Information
 
    *Last Name
    *First Name
     Additional Last / First Name
 
     Last Name (Optional)
     First Name (Optional)
    *Is the buyer a business/LLC?
Yes   No
    *Contact Name for LLC:
 Same as Property Address
    *Address
     
    *City
    *State
    *Zip
 -   
    *Phone
 -   -   Ext.   
     Cell Phone
 -   -   
(A valid phone number must be entered. We do not sell or utilitize your number
  for anything other than official Aquarion business, such as a “Code Red” in the
  event of water outages or other emergencies. If you would prefer to not receive
  these calls, please call our call center or email us at CS@aquarionwater.com.
)
     Email
(We will never disclose your email address)
 
  Attachments (Optional)
 
 
 
  Comments (Optional)
 
 
Note: * Indicates required fields
 
If property is a foreclosure, please attach a copy of the certificate of
foreclosure or fax to 203-445-7308.  You could also email us at
closings@aquarionwater.com.