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TRANSFER STATION ACCOUNT APPLICATION

  1. City of Fairbury

  2. FAIRBURY TRANSFER STATION ACCOUNT APPLICATION

  3. BILLING INFORMATION

  4. FOR SECURITY PURPOSES, do not enter the FEIN # and submit electronically. Please complete this at the time of submission to the City Clerk's Office. Thank you.

  5. TERMS: I agree to pay the City of Fairbury for all charges incurred for services rendered at the Transfer Station (checks payable to Fairbury Transfer Station). I understand invoicing is monthly and payment is due upon receipt.

  6. IDENTIFICATION VERIFICATION:

  7. Title

  8. Leave This Blank:

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