2. Full Customer Name*
4. Address*
6. Customer - Account No.*

8. ---
10. Average Monthly Plan unenrollment

    I understand that after removal, I must wait at least 12 months to be eligible to sign up for the Average Monthly Payment Plan again.
    
    I authorize the City of Edmond to remove the Average Monthly Payment Plan from my City of Edmond utility account.
    
    I am authorized to make contractual obligations on behalf of this account.
    
    Type I AGREE in the authorization box below if you agree with the terms stated above.

12. Authorization*
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14. 1. Receive an email copy of this form.
15. Email address

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16. Submit

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