Payment Arrangement Request Form

Payment arrangement can be submitted to avoid disconnection of your water/wastewater service if you have received a Disconnect Notice.  The entire account balance, as outlined in the notice, must be included in the payment arrangement.  

Please include your name, address, account number if known, the amount you will pay, and the date you will make payment.  You must include a valid email address to receive a response indicating acceptance or denial of the proposed arrangement.  If you have not received a confirming email prior to the scheduled disconnection, please call the Finance Department at 541-942-3346 for more information.   

Submittal of this form indicates that you agree if the payment is not made in full by 5:00 pm on the date promised, the city will disconnect water service without further notice.  If service is disconnected, you will be required to pay the balance due plus a $35 service fee, in cash/money order, before service is restored.  Payment arrangement can not be submitted via this format on disconnect day.