911 Addressing

Applicant Name

Phone Number

Email Address


Electronic Signature

Applicant Status

Type of Structure

When I receive this address this automatically signs me up for garbage service with Panola County and my bill will generate the 1st of the next month. There is a $40 deposit for new service which will be added to my first bill, plus the $11.00 garbage fee. If you need a can, carry this form to the Solid Waste Department at 223 McNeely Road, Courtland, MS 38620 Telephone (662)563-6225