Borough of Danville
239 Mill Street Danville, PA. 17821
Phone 570-275-3091
Fax 570-275-2656
www.danvilleboro.org
Electronic Billing Form
Account No.: ____________________________________________________________________________
Service Address: __________________________________________________________________________
Contact Name / Phone: ____________________________________________________________________
Billing Address: __________________________________________________________________________
City, State, Zip: __________________________________________________________________________
I wish to have my quarterly water and sewer bills electronically delivered to the following e-mail address:
_______________________________________
Authorization Agreement for Electronic Billing
I hereby authorize the Borough of Danville to electronically deliver my quarterly water and sewer bills. I agree
that once I sign up for the electronic bill delivery, I will no longer receive a paper bill. I acknowledge that the
electronic bills will be generated the same time as the paper bills. If no bill is delivered, I am still responsible to
pay the bill by the due date. I may elect to discontinue my enrollment in this plan at any time by notifying the
Borough of Danville.
Signature: ____________________________________________________ Date: ______________________
Return this signed form to:
Borough of Danville
239 Mill Street
Danville, PA 17821
Important Notice: To avoid the bill from being delivered to your junk mail please add
[email protected] to your contacts.
If you should have any questions, please call 570-275-3091 ext. 2