Mosquito Fogging opt-out Form

Instructions: To complete the form, please click print below, sign the form, and return it to City Hall.

FOGGING OPT-OUT FORM

By filling out this form, you are requesting to be put on the opt-out list for the mosquito fogging program for the current mosquito season. I understand I will have to file another opt-out authorization next year.

First Name: Last Name:

Are you the owner/renter of this property?

Email:

Street Address:

City: State: Zip

Phone Number:

Signature:____________________________________

Date:

This authorization will not be accepted unless the form completed accurately and is signed.