2. City of Wayne
   Paperless Water Billing Signup Form

4. E-mail*
6. Water Account Number or Address*

   Your account number can be found on your most recent bill.

8. Customer Name*
10. Contact Phone Number
12. Service Address
14. Mailing Address (if different from Service Address)
16. Please Note

    By signing up for paperless billing, you will no longer receive a bill via the US Post Office. Remember if you change your e-mail address it is your responsibility to submit a new request form. Failure to receive a bill does not alter due date, or exempt you from late fees.

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18. 1. Receive an email copy of this form.
19. Email address

    This field is not part of the form submission.

20. Submit

* indicates a required field