Form Center

By signing in or creating an account, some fields will auto-populate with your information.

Additional Garbage Receptacle Request

  1. Jacksonville, Arkansas
    City of Jacksonville, Arkansas
  2. This form is to request an additional garbage receptacle. There will be an additional charge of $8 per month added to your water bill, and you will be required to keep the receptacle for a minimum of three months.

  3. Arkansas
  4. Please notify proper organization of concerns.
  5. Leave This Blank:

  6. This field is not part of the form submission.