Fillable To: City of Troy Public Works Department Account (City of Troy)

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To: City of Troy Public Works Department Account (City of Troy)

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U.S.A. forms for City of Troy

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Date:
To: City of Troy
Public Works Department Account #
From: ____________________________
(NAME)
____________________________
(ADDRESS)
____________________________
(City, State, Zip)
RE: Exemption from Garbage Pick-up Fees
I hereby certify that the resident located at the address above
generates no trash or garbage of any kind, and wish to be exempted from
the monthly garbage fee.
I understand that no trash of garbage will be picked up from this
address and that I will be charged a tipping fee at the landfill for any trash
or garbage disposed from this address.
___________________________
(Signature)
cc: Utilities Billing Dept.
Trash Route Driver
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To: City of Troy Public Works Department Account (City of Troy)

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Completed 16 July 2020

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