Stolen z-cart interactive

Sanitation Department
39421 South Ave
Zephyrhills, FL 33542
Telephone: (813) 780-0022
Email: publicworksrfa@ci.zephyrhills.fl.us


RE: Sanitation Department
Account Number: _____________________________
Service Address: _____________________________
Cart Number: ________________________________       


Dear Valued Resident:

Please complete this form and contact the City of Zephyrhills Police Department at 813- 780-0050 to file a report. Failure to return this form within 14 calendar days will result in a one-time fee of $60.00 for the cost of the container, delivery and processing.

Please contact our office for additional information, or if you feel this information is inaccurate. 

Respectfully,

Shane LeBlanc
Public Works Director

Upon completion of this form with a valid police case number, statement and signature, please submit via email to the Public Works Department at publicworksrfa@ci.zephyrhills.fl.us.


Police Case No: __________________________
Your statement about your cart:

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

Please be advised that by signing this document you are certifying that your statement is true.
Customer


Signature: _________________________________________________________                   Date:_______________________