Kanab East – Residential Customer Service Agreement | Western Kane County Special Services District

Name*
First Last
Billing Address*
Street Address Address Line 2 City State ZIP Code
Can Address*
Street Address Address Line 2 City State ZIP Code
Phone*
Email*
I wish to receive my bill via email?*
- Yes
- No
I understand I will be invoiced $156.00 annually on June 1st for 12 months of weekly curbside service ($13/month) and that my payment is due within 30 days of the invoice date. If payment is not received within 30 days the residential can will be removed from the premises, and the WKCSSD will require a $100 replacement fee in addition to the $156 annual billing fee for it to be returned. I understand that this agreement will auto renew for an additional 12 months of service with each annual payment received by the WKCSSD. I understand that this is a prepaid agreement for a 12-month period (July-June), and no partial year/pro-rating of fees will be accepted with the exception of initial applications received after July 1st for any new service location. I understand I am responsible to notify the WKCSSD immediately if I sell my property or make any changes to the contact information provided above.
Digital Signature*

Please type your name agreeing to the above.