Town of Youngsville P. O. Box 190 / 134 US 1A South Youngsville, NC 27596 Edit Form I'm Moving from Youngsville Town Limits We are sorry to see you leave the Town Limits of Youngsville. Please fill out the Move Out Form, so that we may pickup your carts and mail a refund (if applicable). Date To Begin End* Service Address*? Full Name* Rent or Own* Renter Owner (Sold) Owner (Renting to New Renter) Owner's Name (if renting) Mailing Address (address to send refund)*? Email* Garbage/Recycling Services Garbage Carts to Pickup* 1 Roll Cart 2 Roll Carts 3 Roll Carts Recycling Carts to Pickup* No Recycling Service 1 Roll Cart 2 Roll Carts Signature/Authorization: Typing your name here constitutes as a binding electronic signature. Full Name for Signature* Signature Date* Co-Applicant Full Name for Signature (type "N/A" if N/A)* Co-Applicant Date I have read and understand the Disclosure.* Yes Yes Participation in the Town’s solid waste program is mandatory by Ordinance. Failure to supply complete required information or supplying misrepresented, inaccurate or misleading information will result in your application being denied. Residents without Garbage Service are subject to fines and penalties.