Request to Cancel Commercial Rubbish Service Form

REQUEST TO CANCEL ADDITIONAL COMMERCIAL RUBBISH SERVICE

I ……………………………………………………………………., the owner of a commercial property at

Lot No: ……… Property Address: ……………………………………………………………………......

Postal Address: ………………………………………………………………………………………………

Business Name: ……………………………………………………………………………………………..

Hereby request the cancellation of the Additional Commercial rubbish service at the above property.

Service to be cancelled: ……………………………………….. (General Service or Recycle Service)

No. of services to be cancelled: …………

Bin to be removed: □ General Rubbish Bin

□ Recycle Rubbish Bin

Phone Number: ……………………… Email Address: ………………………………………………….

…………………………………………

Signature

Return form to: Postal Address: City of Bayswater PO Box 467, MORLEY WA 6943

Email:

Fax: 9272 0665

______

OFFICE USE ONLY

Assessment No. ………. ………………….

Property Address: ……………………………………………………………………….

Actioned by: ………………………………..

Date: ………………….. Cancelled Service Advice Request No's: …………………………..

Date Service Cancelled: ………………………………..