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2. IMPORTANT NOTE:

   Please note that this form is NOT for new CBPU customers. If you would like to start services with the CBPU, and you are not a current CBPU customer, please see our Application for New Service. This form is for current CBPU customers looking to add a new service, transfer services, or stop services. Thank you. 

   Please note that this form was previously called Request to Add, Change, or Stop Services. 

6. First Name*
7. Last Name*
9. Phone Number*
10. Email Address
12. Service Address*
14. City
15. State
16. Zip Code
18. Is there a Secondary Account Holder at this address?*

    This typically applies when there are multiple people on a lease or if you are on a parent or dependent's account.

    1. Yes
    2. No
20. Secondary Account Holder Name

    Please type the name(s) of your secondary account holder(s)

21. Secondary Account Holder Phone Number

    Please provide the phone number(s) for your secondary account holder(s)

23. Is your Mailing Address different from your Service Address?*

    1. Yes
    2. No
25. Mailing Address*
27. City
28. State
29. Zip Code
33. What date do you wish to start, stop, or transfer services?*
    What date do you wish to start, stop, or transfer services?
35. Services I would like ADDED or CHANGED

    1. Electric
    2. Water / Sewer
    3. Internet
    4. Absolute Cable TV / Acclaim
    5. Digital Phone (VOIP)
    6. Garbage
36. Services I would like STOPPED

    1. Electric
    2. Water / Sewer
    3. Internet

    1. Absolute Cable TV / Acclaim
    2. Digital Phone (VOIP)
    3. Garbage
40. DISCLAIMERS

    Please see our Rules, Rates, and Regulations for fees or deposits associated with establishing new service. 

    Activation and Installation fees may apply.

    Telecommunications equipment (i.e. router for GIG Fiber Internet) must be returned upon cancellation of services. Your account will be billed for equipment that is not returned. 

    See all Rules, Rates, and Regulations here. 

    If this form does not cover your request, please feel free to call the CBPU at (517) 279-9531, Monday-Friday, 8:30 a.m. to 5:00 p.m.

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