2. Please complete the online form below to sign-up to have your Village utility bill emailed to you.
4. Personal Information
6. First Name*
8. Last Name*
10. Daytime Phone Number*
12. Village of Potter Account Number*
14. Email Address*
16. Authorization*

    By filling out this form, you authorize the Village of Potter to send your billing statements via email ONLY.
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18. 1. Receive an email copy of this form.
19. Email address

    This field is not part of the form submission.

20. Submit

* indicates a required field