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Request for Disclosure

  1. Burleson - City - Solid -Maroon
  2. Request for Disclosure

    including utility usage, amount due (current and past due), due dates, initiation and/or termination dates, disconnect dates and billing and payment history.

  3. Account information
  4. By electronically signing this form, I attest that I am the authorized account holder of the above account.
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  6. This field is not part of the form submission.