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USER FEE

2. FOR VACANT LOT/REAL ESTATE PAYMENTS
   Click here for vacant lots and real estate.

4. 

6. First Name*

7. MI

8. Last Name *

10. Street Address*

11. Zip Code*

13. User Fee Bill Number*

14. Email Address*

15. Phone Number*

19. Please enter all requested information for all blue garbage totes associated with your user fee bill number.

20. 

22. Tote #1

23. Tote ID #*

24. Tote Size*
    -- Select One --35 Gallon65 Gallon95 Gallon

26. Tote #2

27. Tote ID #

28. Tote Size
    -- Select One --35 Gallon65 Gallon95 Gallon

30. Tote #3

31. Tote ID #

32. Tote Size
    -- Select One --35 Gallon65 Gallon95 Gallon

34. Tote #4

35. Tote ID #

36. Tote Size
    -- Select One --35 Gallon65 Gallon95 Gallon

38. Do you have additional totes?

    1. Yes
    2. No

40. Tote ID #

41. Tote Size
    -- Select One --35 Gallon65 Gallon95 Gallon

43. Do you have additional totes?

    1. Yes
    2. No

45. Tote ID #

46. Tote Size
    -- Select One --35 Gallon65 Gallon95 Gallon

48. Do you have additional totes?

    1. Yes
    2. No

50. Tote ID #

51. Tote Size
    -- Select One --35 Gallon65 Gallon95 Gallon

53. Do you have additional totes?

    1. Yes
    2. No

55. Tote ID #

56. Tote Size
    -- Select One --35 Gallon65 Gallon95 Gallon

58. Do you have additional totes?

    1. Yes
    2. No

60. Tote ID #

61. Tote Size
    -- Select One --35 Gallon65 Gallon95 Gallon

63. Do you have additional totes?

    1. Yes
    2. No

65. Tote ID #

66. Tote Size
    -- Select One --35 Gallon65 Gallon95 Gallon

68. Do you have additional totes?

    1. Yes
    2. No

70. Please type all remaining tote ID numbers and sizes below:

    Put each tote number and size on it's own line separated by a coma (ex: Tote #, Tote Size {press enter) Tote #, Tote Size...)

72. I want to go paperless!

    1. Yes

74. I would like to enroll in Auto Pay!

    1. Yes

76. One-Time Payment
    After you submit this form, click the "One Time Payment" link on the confirmation page to make a one-time User Fee payment by credit card or ACH.

    After you submit this form, click the "One Time Payment" link on the confirmation page to make a one-time User Fee payment by credit card or ACH.

78. Schedule Quarterly Payments
    After you submit this form, click the "Schedule Payments" link on the confirmation page to schedule your quarterly user fee payments.

    After you submit this form, click the "Schedule Payments" link on the confirmation page to schedule your quarterly user fee payments.

80. NOTE: You will not be enrolled in paperless billing unless you provide your e-mail address above.

    NOTE: You will not be enrolled in paperless billing unless you provide your e-mail address above.

Leave This Blank:


82. 1. Receive an email copy of this form.
83. Email address

    This field is not part of the form submission.

84. Submit

* indicates a required field