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2. <i>Forms may not function properly if using Microsoft Internet Explorer 9 (IE9) or earlier. If you experience issues, please call 561-697-2700, or 866-SWA-INFO (866-792-4636) toll-free.</i><br><br>Do not use this form for public records requests. To submit a public records request, visit <a href="/511/Public-Records-Request" target="_blank" >Public Records Requests»</a>

   Forms may not function properly if using Microsoft Internet Explorer 9 (IE9) or earlier. If you experience issues, please call 561-697-2700, or 866-SWA-INFO (866-792-4636) toll-free.
   
   Do not use this form for public records requests. To submit a public records request, visit Public Records Requests»

6. If you would like to speak to a Customer Information Services representative by phone, call 561-697-2700, or toll free from southern and western Palm Beach County at 866-SWA-INFO (866-792-4636).

   If you would like to speak to a Customer Information Services representative by phone, call 561-697-2700, or toll free from southern and western Palm Beach County at 866-SWA-INFO (866-792-4636).

10. Name

12. Address

14. City

15. State

16. Zip

18. Telephone

19. Extension

21. Email*

23. What is the nature of your request?

    1. Billing Question
    2. Collection Day Information
    3. Collection Service Problem or Question
    4. Illegal Dumping or Litter
    5. Neighborhood Cleanup
    6. Commercial Assessment
    7. Residential Assessment

    1. Recycling
    2. Disposal Facility Complaint
    3. Odor Complaint
    4. Traffic Complaint
    5. SWA Policy or Program
    6. Technical Information on SWA Facilities
    7. Other

25. How did you hear about our website?

    1. Mailer
    2. Newspaper
    3. Radio

    1. Television
    2. SWA Vehicle Bumper Sticker
    3. Other

27. Comments

29. Thank you for your comments. We look forward to serving you. <br><br> <b>Notice</b><br> Florida law requires that we post the following statement:<br><br> "Under Florida law, email addresses are public records. If you do not want your email address released in response to a public records request, do not send electronic mail to this entity. Instead, contact this office by phone or in writing."<br><br> The Solid Waste Authority regrets any inconvenience this may cause.

    Thank you for your comments. We look forward to serving you.
    
    Notice
    Florida law requires that we post the following statement:
    
    "Under Florida law, email addresses are public records. If you do not want your email address released in response to a public records request, do not send electronic mail to this entity. Instead, contact this office by phone or in writing."
    
    The Solid Waste Authority regrets any inconvenience this may cause.

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31. 1. Receive an email copy of this form.
32. Email address

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