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New Acc®urttr: ,. RESIDENTIAL. COMMERCIAL <br /> Name- <br /> Doing Business <br /> AS Aatt, e dmq'pavl-�t, GZ <br /> Service Address � �© � �Y/�(/� 1��/� �L ��%"✓��� . <br /> Mailing Address <br /> (if different) <br /> Phone Number <br /> E Mail Address(optional) _ For E-Bills <br /> Date to Connect Service <br /> Dumpster <br /> Note:Copy of rental agreement or lease must be shown if applicant does flot own-the,property, <br /> The City-of Zephyrhills recognizes that an indiviidual's driver's license number is a unique form of identification that, <br /> can be utilized to obtain sensitive information regarding that particular individual. However,the City of Zephyrhills <br /> must collect Drivers License numbers under certain circumstances in order for the City to be able to properly.perform <br /> its duties and functions as a municipal corporation and in order to ensure that such duties and functions are <br /> performed accurately and efficiently. <br /> THE CITY OF ZEPHYRHILLS.COLLECTS YOUR DRIVERS LICENSE NUMBER ONLY FOR THE FOLLOWING <br /> PURPOSES: <br /> CLASSIFICATION OF ACCOUNTS IDENTIFICATION <br /> CREDIT WORTHINESS OR COLLECTIONS BILLING AND.PAYMENTS <br /> DATA COLLECTION, RECONCILIATION AND TRACKING <br /> NEW UTILITY ACCOUNT APPLICATION <br /> POLICE STATEMENTS AND ARRESTS FOR THE VERIFICATION OF IDENTITY <br /> Each individual who provides a Drivers License number to the City of Zephyrhills shall be provided with a.copy of this <br /> notice_ <br /> /n <br /> .�c� ZL2-Z <br /> Signarare ,pate <br />