Fillable Form 959 Utility Billing Payment Plan Agreement (City of Borger, Texas)

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Form 959 Utility Billing Payment Plan Agreement (City of Borger, Texas)

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The Form 959 Utility Billing Payment Plan Agreement (City of Borger, Texas) form is 1 page long and contains:

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File type: PDF

U.S.A. forms for City of Borger, Texas

BROWSE CITY OF BORGER, TEXAS (TX) FORMS

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Utility Billing
Payment Plan Agreement
City of Borger Department of Finance
PO Box 5250, Borger, TX 79008-5250
Phone: (806) 273-0918 · Fax: (806) 273-0911
www.borgertx.gov
Utility Payment Plan Agreement Page 1 of 1
Official Use Only:
PP
Contract
Entered:
Account Information
Name:
Telephone:
Cell Phone:
Email Address:
DL State / #:
SSN:
Service Address:
Account #:
Plan Information
Staff Use Only
Plan Start Date:
Down Payment:
Remaining Balance:
# of Installments:
Monthly Payment Amount:
Policy
For Utility accounts (Commercial, Residential, Industrial and/or refuse only) with a balance at or prior to August 1
st
, 2020:
a. To avoid termination of service, payment of 1/12
th
of the current and outstanding balance is due on or before the due date of the
current bill.
b. Each month following, the current amount due plus an additional 1/12
th
of the outstanding balance is due on or before the due
date of the successive bill.
c. At the discretion of the Utility Billing Supervisor, any late fees remaining on the account, but no more than twelve (12) months, may
be waived if the customer pays the current and past due balance in full.
d. Failure to pay as agreed will result in termination of service. If service is disconnected, payment of the amount required to bring
the plan current (all past due current and payment balances) will be required for reinstatement of service.
e. Only one payment plan will be allowed per calendar year per customer.
For utility accounts (commercial, residential, industrial and/or refuse only) a past due balance occurring after August 1
st
, 2020:
A degree of discretion and/or leniency may be exercised by Utility Billing personnel to help customers through a difficult time; however,
discretion should not be frequently exercised with habitual customers and shall conform to the following guidelines.
a. Any payment arrangement shall be structured so that the current balance does not increase over the beginning balance at the
start of the plan (includes future bills).
b. To avoid termination of service, immediate payment of the current balance plus at least 1/3
rd
of the outstanding balance is due
on or before the due date of the bill.
c. At the discretion of the Utility Billing Supervisor, late fees since the last zero balance, but no more than three (3) months, may be
waived if the customer pays the current and past due balance in full.
f. Failure to pay as agreed will result in termination of service. If service is disconnected, payment all past due balances will be
required for reinstatement of service.
d. Only one payment plan will be allowed per calendar year per customer.
e. In no instance shall a payment plan extend longer than three (3) months
Applicant Information
I, the undersigned, do hereby acknowledge and agree to the terms and policies provided herein. I understand that the
sum listed may represents charges for water, sewer, garbage, vector control and/or other charges normally charged to
billing accounts and may include any special service charges or fees needed to maintain this account. I understand
and further acknowledge that the City of Borger will disconnect services to this address, without notice, if this agreement
is broken. I also understand that no more than one payment plan will be allowed per calendar year.
Applicant Signature:
Date:
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Form 959 Utility Billing Payment Plan Agreement (City of Borger, Texas)

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Completed 19 July 2020

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