Occupancy Change Form

2. Occupancy Change Form

   Utilize this form to notify the City of Andover that you are either moving into a new residence or moving out of a residence.  You can also contact the utility billing department at (316) 733-1303 ext. 410 or by email at pbabb@andoverks.com.

3. Today's Date
   Today's Date
5. Resident's First Name*
6. Resident's Last Name*
8. Service Address*
10. City
11. State
12. Zip
14. Mailing/Billing Address
16. City
17. State
18. Zip
20. Phone Number*
22. Ownership Status*

    1. Rental
    2. Owner
24. Change Status*

    1. Moving In
    2. Moving Out
26. If moving out, please indicate address of where you'd like final bill mailed.
28. City
29. State
30. Zip
32. Closing Date for Sale or Purchase*
    Closing Date for Sale or Purchase
34. Enroll in Paperless Billing

    1. Yes - If Yes please submit email address
    2. No
36. Email Address
38. Enroll in Trash Service

    1. Yes
    2. No
40. If at any point, you have any questions, contact the City of Andover utilities at Utilities@andoverks.com
Leave This Blank:


42. 1. Receive an email copy of this form.
43. Email address

    This field is not part of the form submission.

44. Submit

* indicates a required field