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2. 
4. Budget Billing
   Budget Billing averages out your monthly payment amount to help you stay on budget year-round. It's a free program for qualifying customers. To qualify you must have lived at your current address for at least the past twelve (12) months and your account must be current with no past due balance.
6. Complete and submit your Budget Billing enrollment form
   Fill in the following information and submit the form to enroll. Your application will be reviewed and if you qualify for the program it will take effect on the next billing cycle.
8. Account #*
   Wastewater Account
10. First Name*
11. Last Name*
13. Service Address*
15. Mailing Address
    Only if different from service address.
17. City
    Mailing Address City
18. State
    Mailing Address State
19. Zip Code
    Mailing Address Zip
21. Email Address
22. Phone Number
24. Terms and Conditions
    I would like to enroll in the Budget Billing Program under the following conditions:
26. The Town of Sahuarita will calculate the budget billing amount by averaging the past twelve (12) months metered water consumption at your current service address. The budget billing amount will be reviewed periodically and will be increased or decreased should actual water usage or fees vary substantially from what was used to calculate the budget amount or should the Sahuarita Wastewater Utility have a rate change.
28. The budget payment must be paid by the due date as indicated on the billing statement. Late payments may result in your account being automatically removed from the program. Upon removal, your account will be settled. Any credit balance will be applied toward your past due amount and any debit balance will be added to your past due amount.
30. Either party, the Town of Sahuarita or myself, may cancel participation in this program at any time. At such time, or when the account is closed, any outstanding credit or debit balances will be applied to the next bill.
32. Authorizing Signature*
    Type first and last name to accept the terms and conditions.
33. Date*
    Date
    Date of form submittal
Leave This Blank:


35. 1. Receive an email copy of this form.
36. Email address

    This field is not part of the form submission.

37. Submit Submit and Print

* indicates a required field