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Water/Sewer Billing Paperless Invoicing Authorization

  1. I authorize the City of East Grand Rapids to e-mail my bill for the account listed above. I understand that I am responsible for the bill and any penalties incurred for late payment, even in the event that no bill is received. I will notify the City if my e-mail address changes. No paper bill will be processed. I also understand that all information provided will remain confidential.

  2. THIS FORM CANNOT BE PROCESSED WITHOUT YOUR NAME, ADDRESS AND E-MAIL ADDRESS ABOVE, AND WITHOUT YOUR SIGNATURE OR CHECK MARK IN THE TERMS/ CONDITIONS BOX.

  3. Terms/Conditions:*

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  5. This field is not part of the form submission.