This is a one page form

To complete this form you will need:

Your Name
Address OR Payment Reference
Email Address
Telephone Number
Date Moving
New Address
Meter Reading if applicable

Items marked * must be filled in.

Your details

Title:

First name:

Surname:

Email Address :

Telephone:

Do you have a payment reference?
Show me

Yes No

Payment ref no :

House Number:

Street:

Town:

Town 2:

Postcode:

Were you a tenant?

Yes No

If yes, please provide landlord's address.

Full name:

House number/name:

Street:

Town:

Postcode:

Do you know the name of the incoming occupier?

Yes No

Please provide the name of the new occupant of this address, if known:

Preferred method of contact:

Personal data may be used for tracing and collection purposes if payments are not maintained

Date of Birth:

National Insurance number:

New address

Are you moving within the UK?

Yes No

House number / name:

Street:

Town:

Town 2:

Postcode:

Zip Code:

Country:

About your move

Date moving out of property:

Meter reading:
(If applicable)

How to read your meter

Please note if you require a final meter reading from Southern Water we will need two full working days notice to arrange a reading.

Payment details

Your account must now be settled in full. Your final bill will be sent to your new address. If you have a meter a closing balance will be confirmed once a final reading has been taken and the closing invoice will be sent to you at your new address for payment.

Please refer to our Privacy Statement to understand how we may use your personal information.

Please now Submit to send the completed form to Southern Water.