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Get and Sign Get Cap Org Form
#:____________________
Utility Company___________
Whose name on the bill__________________________
Amount owed : $_______ Due Date: ____________
Termination notice? YES
NO
Relation if bill is not in your name:_______________
Is this a termination notice? YES
NO
Gas/Propane Acct. #:___________ Utility Company:______________Amt. owed:_________ Due Date:_________
Whose name on the bill:________________________ Relation if bill is not in your name:________________
Is this a termination...
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