Hisega Meadows Water, Inc

Deposit Refund Request Request Form

Water Account Owner(Required)

Water Account Number

Phone(Required)

Email(Required)

Water service address(Required)

Street Address Address Line 2 City State ZIP Code

Date of sale / closing(Required)

The refund of a deposit is subject to the following conditions: 1. The customer must submit this form (electronically or by mail). 2. The customer has sold the property listed as the service address. 3. The customer has no outstanding balance on their account.

Refund method(Required)

Apply my deposit refund as credit to my water service account and issue a check for any remaining balance.

Issue me a check for my full deposit refund. (Check refunds can take 3-4 weeks to process)

Mailing address for refund check(Required)

Street Address Address Line 2 City State ZIP Code

Signature(Required)

Typed name acts as legal signature

Today's date(Required)

1179

Form can also be printed and mailed to:

Hisega Meadows Water, Inc
C/O 5310 Ebony Place
Piedmont, SD 57769

Hisega Meadows Water, Inc Links

Drinking Water Reports

Annual drinking water report
Drinking water test results (hardness)
SD DANR Drinking Water Program

Resident Forms / Info

Owner / Board Member Forms

Annual Information Request Form

Water System Portal / Payments

Hisega Meadows Water, Inc

Deposit Refund Request Request Form

Hisega Meadows Water, Inc Links

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