Fillable MILITARY SANITATION HOLD FORM (City of Pooler)

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MILITARY SANITATION HOLD FORM (City of Pooler)

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MILITARY SANITATION
HOLD FORM
RECONNECT DATE ___________/ ___________/ _____________
Please submit this application along with a
City of Pooler
copy of deployment orders and a photo ID.
Utility Billing Department
100 US HWY 80 SW
Pooler, GA 31322
Ph (912) 748-7261
utilitybilling@pooler-ga.gov
Email address __________________________________________________
*Temporary suspension of sanitation services must be requested within 24 hours of the effective date of the suspsension. Services will be reactivated
the month following the ending date of deployment.
___________________________________________________________
OFFICE USE ONLY
Applicant/Owner Information
ACCT_________________________________________________________________
________________________________________________________________________________________________________________________
Today's Date _________/__________/___________
Service Address_______________________________________________
Employer__________________________________________________________________________________________
Owners Name _____________________________________________________________________________________________________________
HOLD DATE ____________/ ___________/ ____________
BY:_________________________________________________________________
Mailing Address ___________________________________________________________________________________________________________
Email _______________________________________
Phone # ( ) -
SSN of Owner ________________________________________
Phone # ( ) -
Fax # ( ) -
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MILITARY SANITATION HOLD FORM (City of Pooler)

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Completed 4 August 2020

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