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2. 

3. City of Kingsford

   The Progressive City

5. Utility Billing Email Cancellation Form

7. Name*
8. Email Address*
10. Address*
12. City*
13. State*
14. Zip Code*
16. Phone Number*
17. Fax Number*
19. Electronic Signature Agreement*

    I hereby request the City of Kingford to cease electronic delivery of my utility bill. By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
21. Electronic Signature*
23. City of Kingsford

    305 S. Carpenter Avenue, Kingsford, Michigan 49802

    PH: (906)774-3526

    Fax: (906)774-7093

    City of Kingsford's Website

    This institution is an Equal Opportunity Provider and Employer

Leave This Blank:


25. 1. Receive an email copy of this form.
26. Email address

    This field is not part of the form submission.

27. Submit

* indicates a required field