Senior Residential Garbage Discount[Type here]Finance Department
Phone: 334.595.0150
Fax: 334.361.3608
revenue@prattvileal.gov
APPLICATION FOR SENIOR RESIDENTIAL GARBAGE DISCOUNT
Date: ____ /____ /____
To Whom It May Concern –
I hereby certify that I have provided proof of income showing that I am eligible for an exemption from the
increase in residential garbage pickup fee under the code of Ordinance of the City of Prattville, Chapter 66
Municipal Utilities and Services, Article IV, Section 66-430 Billing Procedure; Exemptions because I am
over the age of 65 and on a fixed income, which is defined as living solely on Social Security Benefits,
disability benefits included, and in proceeds from retirement benefits, and who is not gainfully employed,
as checked below, shall be granted a $2.00 discount from the prevailing fees for garbage handling and
pickup service:
_____ Over the Age of 65
_____ Social Security Benefits
_____ Disability Benefits
_____ Retirement Benefits
_____ Not Gainfully Employed
I further understand that should my financial status change at any time eliminating me from the discount
status, that I am legally and morally obligated to notify the City of Prattville Finance Department at
(334)-595-0150 so that my garbage bill can be adjusted to reflect my correct charge for service.
By signing this application, I am certifying that the facts provided above relative to my financial status are
true and correct. I understand that I must apply for this exemption status on an annual basis. If re-
application is not made by November 1, my garbage bill will be raised to the current residential level.
Name: ___________________________________Signature: __________________________________
Print Name as Shown on Prattville Water Works Board Bill (if applicable): _________________________
Prattville Water Works Board Bill Account Number (if applicable): _______________________________
Address of Garbage Service: ____________________________________________________________
City: ______________________ State: ______________________ Zip: _______________________
RETURN APPLICATION TO:
The City of Prattville
Finance Department
ATTN: Accounting Specialist
PO Box 680190
Prattville, AL 36068-0190