Recycle Fee Adjustment - City of Decatur, IL

Recycling Fee Adjustment Request

This form is to be used when requesting a recycling adjustment for the City of Decatur's Municipal Utility Bill.

The recycling fee will only be adjusted if the water usage indicates the property
was vacant for the entire billing period. No adjustments will be made for partial billing periods.

First Name *

(Enter the First Name as it appears on the bill)

Last Name *

(Enter the Last Name as it appears on the bill)

Business Name, if applicable

(Enter the Business Name on the bill)

Primary Telephone Type *

Primary Telephone Number *

(Enter the best telephone number to contact you during the hours 8 am to 5 pm)

Alternate Telephone Type

Alternate Telephone Number

Service Address *

(Enter the Address the adjustment is being requested)

Account Number *

(Enter the City of Decatur Utility Billing account number for the service account above)

Email Address *

(Enter email for account)

Confirm Email Address *

Confirm Email

This Property will be vacant starting *

Anticipated Length of Vacancy

(Enter anticipated length of Vacancy -- example 1 month, 6 months, unknown, etc. Max 100 characters)

I certify the information provided above is true and that I am the property owner, agent, or authorized payee of said premises.

Agreement Confirmation *

Check this box to indicate you have read and understand the above agreement

Date Submitted

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