eBill Authorization

2. Utility Billing Division
   Telephone: 407-703-1727
   Fax: 407-703-1630
   Website: www.apopka.net
4. Date
   Date
6. First Name
7. Last Name
9. Business / Account Name
11. Address
13. City
14. State
15. Zip Code
17. Phone Number
18. Account Number*
20. Email Address*
21. I confirm my subscription to the City of Apopka’s weekly email newsletter.*

    1. Yes

    1. No

    The newsletter will be delivered to the email on this account. To unsubscribe visit http://www.apopka.net/list.aspx.
23. By submitting this form, I hereby agree to no longer receive a monthly bill statement via the US Postal Service. I will receive a notification by e-mail that a new bill has been created and is available for viewing. If my e-mail address changes, it will be my responsibility to notify the City of Apopka Utility Billing Division of the change so I can continue to receive notifications. This will remain in effect until I notify the City of Apopka Utility Billing Division to discontinue. All other policies, collections, penalties or fees of the City of Apopka will remain the same as if a paper bill had been mailed. E-mail addresses are public records under Florida law and are not exempt from public records requirements.
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