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Paperless Utility Billing

2. Note
   Paperless billing will begin (or be discontinued) by filling out this form. The service starts (or ends) with your next quarterly utility bill. Please contact the Treasury Office at 269-329-4455 with any questions.

   Paperless billing will begin (or be discontinued) by filling out this form. The service starts (or ends) with your next quarterly utility bill. Please contact the Treasury Office at 269-329-4455 with any questions.

4. Utility Account Holders' Name

5. Email Address

7. Address (Where utility services are received)

9. City

10. State

11. Zip Code

13. Daytime Phone Number

17. Mailing Address

19. City

20. State

21. Zip Code

25. Do you wish to initiate or discontinue paperless billing?

    1. Initiate
    2. Discontinue

27. Do you wish to continue receiving a paper bill?

    1. Yes
    2. No

Leave This Blank:


28. 1. Receive an email copy of this form.
29. Email address

    This field is not part of the form submission.

30. Submit

* indicates a required field