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2. 
4. REFUND REQUEST FORM
   To request a sewer payment refund, please complete the information below and submit or print and send to: 375 W. Sahuarita Center Way, Sahuarita, AZ 85629. Please allow seven to ten business days for processing. The refund amount requested cannot exceed the available credit balance on your account. Please contact us at 520-344-7101 if you have any questions.
6. Date:
7. Account Number:
8. Amount:
10. Customer Name:
12. Mailing Address:
14. City
15. State
16. Zip
18. Reason for refund request:
20. Signature:
22. Town of Sahuarita - 375 W. Sahuarita Center Way - Sahuarita, AZ 85629 - 520-822-8844 - sahuaritaaz.gov
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24. 1. Receive an email copy of this form.
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