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Change Level of Service for Trash Collection

2. There is a $10 fee to exchange trash containers, which will be added to your trash bill. Once this form is submitted, you will receive a call from the Town to arrange the day that the swap will be made.

4. Name

6. Account Number (if known)

8. Service Location Address

10. Billing Address

12. City

13. State

14. Zip Code

16. Email Address

18. Phone Number

20. Current Service Level
    -- Select One --20 Gallon Can - $16.00/month35 Gallon Can - $22.75/month64 Gallon Can - $29.00/month96 Gallon Can - $35.75/month160 Gallon Can - $41.75/month

22. New Service Level
    -- Select One --20 Gallon Can - $16.00/month35 Gallon Can - $22.75/month64 Gallon Can - $29.00/month96 Gallon Can - $35.75/month160 Gallon Can - $41.75/month

24. Effective Date
    Effective Date

Leave This Blank:


25. 1. Receive an email copy of this form.
26. Email address

    This field is not part of the form submission.

27. Submit

* indicates a required field