2. Level Payment Plan Application
4. Date*
6. First Name*
7. Last Name*
8. Account Number*
10. Address1*
12. Address2
14. City*
15. State*
16. Zip*
18. Level Payment Plan Instructions
    I wish to apply for the level payment plan for utilities (electric, water, storm drainage, sewer, trash) on the above account. I understand and agree to abide by the following terms and conditions:
20. 1. To be eligible for the Level Payment Plan, I must have resided in Eudora for the previous twelve (12) months, and have established a credit history with the City for that same twelve (12) month period, having no delinquent payments, or checks returned to the City for insufficient funds. 2. I have read and understand the Level Payment Guidelines and the City staff has fully explained how my monthly level payment amount is calculated. 3. I will remain enrolled on the level payment plan until I request cancellation in writing, or I am removed by the City for violating any of the Level Payment Guidelines.
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