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New Ace®>r nt RESIDENTIAL COMMERCIAL <br /> Name <br /> Doiti9 Busines <br /> As <br /> Service Address <br /> Mailing Address �� �� 3� '� ��p1G11')CQ; <br /> (if tfiffererri) � / <br /> Phone Number <br /> E Mail Address(optional) ,For E-Bills <br /> Date to Connect Service <br /> Dumpster <br /> Nate:Copy of rental agreement or lease must be shown if applicant does f lot own the property, <br /> The City of Zephyrhills recognizes that an individual'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 Zephyrhilis <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 /> CREDITWORTHINESS 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 /> r <br /> Signardre ,Date <br /> e <br />