K-4 - One-time Water and Sewer Adjustment at 99 Brown Street

P.O. BOX 259 TIFFIN, IA 52340 (319) 545-2572 KEVIN WILSON PO BOX 421 99 BROWN ST TIFFIN, IA 52340 <table> <tr> <th>Account Number</th> <th>AMOUNT DUE</th> </tr> <tr> <td>01-01000480-00</td> <td>$134.52</td> </tr> <tr> <th>Due Date</th> <th>After Due Date Pay</th> </tr> <tr> <td>2/20/2022</td> <td>PAID BY DRAFT</td> </tr> <tr> <th>Account Name</th> <td>KEVIN WILSON</td> </tr> <tr> <th>Service Address</th> <td>99 BROWN ST</td> </tr> <tr> <th>Amount Enclosed</th> <td></td> </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>Name</th> <th colspan="3">Service Address</th> <th colspan="2">Account Number</th> </tr> <tr> <td>KEVIN WILSON</td> <td colspan="3">99 BROWN ST</td> <td colspan="2">01-01000480-00</td> </tr> <tr> <th>Status</th> <th>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 12/16/2021 To 1/14/2022</td> <td>29</td> <td>1/24/2022</td> <td>2/21/2022</td> <td>2/20/2022</td> </tr> </table> Usage CURRENT READING 1,587 PREVIOUS READING 778 USAGE 8,090 PREVIOUS BALANCE $80.56 PAYMENTS $80.56- ADJUSTMENTS $0.00 PENALTIES $0.00 PAST DUE AMOUNT $0.00 WATER 51.50 SEWER 57.93 GARBAGE 13.50 STORM WATER 3.00 RECYCLING 5.50 Tax 33.09 CURRENT BILL $134.52 AMOUNT DUE $134.52 PAID BY DRAFT