Please fill out the following application to apply for a Disabled Residents sewer discount: Date: Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year20222023202420252026 Sewer Account #: Owner's Name: Address: Block (If Known): Lot (If Known): Please attach a copy of all selected documents for Authority approval.Proof of Ownership Choose One: Mortgage Statement Title Report Deed Tax Bill Proof of Ownership document copy Files must be less than 2 MB.Allowed file types: gif jpg jpeg png txt pdf doc docx. Proof of Residency Choose One: Gas Bill Electric Bill Water Bill Phone Bill Proof of Residency document copy Files must be less than 2 MB.Allowed file types: gif jpg jpeg png txt rtf pdf doc docx. Proof of Disability Choose One: Social Security Award Letter Social Security Statement Signed Doctors Letter Proof of Disability document copy Files must be less than 2 MB.Allowed file types: gif jpg jpeg png txt rtf pdf doc docx. Leave this field blank
