Garbage Service Application (City Resident Only)

form.antibot { display: none !important; } You must have JavaScript enabled to use this form.

Name on Account: *

Date for Service Activation:

edit-submitted-date-for-service-activation-month

edit-submitted-date-for-service-activation-day

edit-submitted-date-for-service-activation-year

New services activations are only available Monday - Friday (with the exception of holidays)

Garbage Can Size *

95 Gallon (Standard size)

65 Gallon

Email Address: *

Service Address: *

Mailing Address: *

City: *

State: *

Zip Code: *

Cell Phone #: *

for example 000-000-0000

Driver License: *

Files must be less than 10 MB.
Allowed file types: gif jpg jpeg png bmp pdf doc docx.

Proof of Ownership/Lease Agreement *

Provide proof of ownership or rental/lease agreement
Files must be less than 10 MB.
Allowed file types: gif jpg jpeg png bmp pdf doc docx.

Employer: *

Work Number #: *

for example 000-000-0000

Name of Emergency Contact: *

Emergency Contact Number #: *

Terms and Conditions: *

Yes Weekly Garbage Service $19.90/month. Each customer will be billed for the previous month's garbage service. The customer will be responsible for that month's bill whether they receive a bill or not. Please contact City Hall (706) 265-3256 if you do not receive a bill. Payment for Garbage Service is due upon receipt each month. A $10.00 late fee penalty is charged on all late payments after the fifteenth (15th) of each month. When I move, I will submit a termination form to the City of Dawsonville at least three (3) days in advance. $60.00 refundable deposit required at the time this application is made, plus an administration fee of $15.00 for a total due of $75.00 All Returned Check will have a Returned Check Service Charge of $35.00. All fees and rates are subject to change.

Authorization for DEPOSIT- ONE TIME CHARGE

I (we) authorize CITY OF DAWSONVILLE, hereinafter called COMPANY, to process a ONE TIME CREDIT CARD PAYMENT of $75.00, plus a 3% processing fee, to be applied to the deposit for requested service(s). This is a ONE TIME charge and DOES NOT establish a recurring payment. Please enter a valid credit card number and the 4-digit expiration date. i.e., 01/21.

Signature: *

Date:

edit-submitted-date-month

edit-submitted-date-day

edit-submitted-date-year

Message

Garbage Service Application (City Resident Only)

Contact Information