Forms • Garbage 2d Cart Opt-Out/Pickup 2d Cart

Garbage 2d Cart Opt-Out/Pickup 2d Cart

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What is your first and last name?*

What is the name on the Utilities account? (If different than you name)

What is your street address?*

What is your phone number?*

What is your email address?*

Is this a residential or commercial property?*

Residential

Commercial

By checking "I agree" below, you notify the Town of Southern Pines that you do not wish to continue with a second garbage cart after December 31, 2024 and acknowledge that only one garbage cart will be picked up by our vendor at your location starting January 1, 2025. *

If you are no longer going to have a second garbage cart collected at your location, do you want us to dispose of your second cart? You may choose to keep it for other uses. *

By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.*

* indicates required fields.

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