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Special Payment Plan Request Form

  1. Agreement*

    I hereby certify that I am requesting this payment plan as a result of a COVID-related issue. I agree that I am entering into an agreement to pay my outstanding charges over the period specified in this document. I further agree that I understand that all payment plan payments are due on the due dates of my monthly statements along with current charges for each month until the plan amount is paid in full. I understand that failure to make payments as agreed will result in disconnection of utility services.

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