Milpitas Sanitation Credit Application Request - Milpitas Sanitation

Milpitas Sanitation Credit Application Request

* = Required Information

When submitting a credit application for Debris Box, Multi-Family Bin or Commercial Bin and Cart Service, a completed request for service form must be included with the credit application.

If you are unable to complete or submit this form, please call us at 408-988-4500.

Company / Owner name:

Email *

Site address: *

Address Line 1

City

State

Zip Code

Site phone number: *

Site fax number:

Site email: *

Billing address: *

Address Line 1

City

State

Zip Code

Billing phone number: *

Billing fax number:

Billing email *

Type of entity:

Corporation
Sole / Proprietor / Owner
Partnership

Name