K-3 - One-time Water and Sewer Adjustment - 465 Iris Court

P.O. BOX 259 TIFFIN, IA 52340 (319) 545-2572 SCOTTIE MOLER 465 IRIS CT TIFFIN, IA 52340 <table> <tr> <th>Account Number</th> <th>AMOUNT DUE</th> </tr> <tr> <td>01-01004580-08</td> <td>$198.04</td> </tr> <tr> <td>Due Date</td> <td>After Due Date Pay</td> </tr> <tr> <td>8/20/2023</td> <td>$207.94</td> </tr> <tr> <th colspan="2">Account Name</th> </tr> <tr> <td colspan="2">SCOTTIE MOLER</td> </tr> <tr> <th colspan="2">Service Address</th> </tr> <tr> <td colspan="2">465 IRIS CT</td> </tr> <tr> <th colspan="2">Amount Enclosed</th> </tr> </table> There will be a charge on all returned checks. Please return this portion with your payment. When paying in person, please bring both portions of this bill. CUSTOMER ACCOUNT INFORMATION - RETAIN FOR YOUR RECORDS <table> <tr> <th rowspan="2">Name</th> <th colspan="3">Service Address</th> <th colspan="3">Account Number</th> </tr> <tr> <th colspan="3">SCOTTIE MOLER</th> <th colspan="3">465 IRIS CT</th> <th colspan="3">01-01004580-08</th> </tr> <tr> <th>Status</th> <th colspan="2">Service Dates</th> <th># Days</th> <th>Bill Date</th> <th>Penalty Date</th> <th>Due Date</th> </tr> <tr> <td>Active</td> <td>From</td> <td>To</td> <td># Days</td> <td>7/31/2023</td> <td>8/21/2023</td> <td>8/20/2023</td> </tr> </table> Usage CURRENT READING 28,475 PREVIOUS READING 26,886 USAGE 15,890 <table> <tr> <th></th> <th>WATER</th> <th>SEWER</th> <th>STORM WATER</th> <th>Tax</th> <th>CURRENT BILL</th> <th>AMOUNT DUE</th> <th>AMOUNT DUE AFTER 08/20/2023</th> </tr> <tr> <td></td> <td>94.40</td> <td>94.98</td> <td>3.00</td> <td>5.66</td> <td>$198.04</td> <td>$198.04</td> <td>$207.94</td> </tr> </table>