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New Account:: � RESIDENTIAL COMMERCIAL <br /> Name <br /> Doing Business <br /> As <br /> Serv'rc A <br /> Mailing Address <br /> (if different) <br /> Phone Number D �' % <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 Ilot 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 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 /> 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 /> Signarure Date <br />