Newnan, GA · Coweta County
Backdoor Disability Collection Exemption Application
This application requests backdoor residential waste collection for a customer whose disability limits their ability to deliver solid waste to the curbside.
What this form is
The application includes a health care provider certification about the customer's disability and the customer's certification that they cannot deliver their own solid waste to the curbside. By signing, the customer authorizes the waste hauler to enter private property and collect residential waste from the back door at regularly scheduled pickups. The document does not state when the city requires the application.
Who needs it
A customer who cannot deliver their own solid waste to the curbside may use this application with a health care provider's certification.
How to submit it
Email the completed form to [email protected].
About notarization
This document is signed without a notary; the health care provider and customer sign and date their certifications.
How to submit this form
- 1
Download the Application
Download the Backdoor Disability Collection Exemption Application PDF.
- 2
Complete the Certifications
Have a health care provider complete the provider certification, then fill in the customer certification and contact information.
- 3
Sign and Date
The health care provider and customer should sign and date their respective certifications.
- 4
Email the Form
Email the completed form to [email protected].
Frequently asked questions
- What does the Backdoor Disability Collection Exemption Application request?
- It requests backdoor residential waste collection for a customer who cannot deliver solid waste to the curbside. The customer authorizes the waste hauler to collect waste from the back door.
- Who completes the application?
- A health care provider certifies the customer's disability, and the customer completes a separate certification about being unable to deliver their own solid waste to the curbside.
- How do I submit the application?
- Email the completed form to [email protected], as directed on the application.
- Do I need a notary for this application?
- No. The health care provider and customer sign and date their certifications; the document does not require notarization.
Need something notarized?
This Backdoor Disability Collection Exemption Application doesn’t need a notary — but if you have another Newnan form that does, a commissioned online notary can help.