E-Statement Request Form

Complete and submit the form below electronically OR you can download our printable form, complete and drop off, mail or fax to our offices.

  • I would like to begin receiving my statements/invoices/notices electronically to the email address stated above. By signing this e-statement request form I authorize Perry’s Solid Waste Disposal to email all future statements/invoices/notices.
  • Date Format: MM slash DD slash YYYY