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Request for Assistance ACH Payment

CLICK HERE to download form & fill out at a later date

Request for Assistance Policy

For questions about your account contact 785-966-8032

All requests for assistance to remove residential household waste are to be made through the PBPN Division of Planning & Environmental Protection and will only serve residents of the Potawatomi Reservation.

Only household material will be accepted (Example- furniture, appliances, electronics, construction materials)

Tires are not accepted in Request for Assistance Policy application. Tire Disposal Form is required.

Reduced Rate Requirements – Must meet all four requirements:

1. Must reside on the Reservation
2. Must be listed as head of household/owner of home
3. Must be 62+ years of age
4. Tribal member of PBPN

A one-time fee exemption will be allowed per application annually.

If you do not meet the above requirements, then the following policies apply:

  • $20.00 payment for one small truck load – Must be paid at time of request to be put on the waiting list
    • After one load has been disposed another request from and deposit must be filed with the PBPN Division of Planning & Environmental Protection to be put back on waiting list for additional load

Exemptions: There will be no charge to remove brush or vegetative materials

Payment is due at time of request. No refund will be issued once items have been removed. Cancellation and deposit will only be refunded if applicant is still on the waiting list

  • Payment Details

    *This information is required
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  • Reduced Rate Section (Reduced rate guidelines listed ABOVE)

  • Billing Details

    *This information is required
    By checking the "I accept the Terms and Conditions" checkbox below I authorize my bank to debit my specified account for the amount of my payment. This is a one-time payment which will occur on the next business day or as soon as practical thereafter. If my payment cannot be completed for any reason, including insufficient funds or error in the information which I submitted, I will retain the same liability, which is my sole responsibility, for payment as though I had not attempted to make the payment. I also understand that additional fees and penalties may be collected to the extent of applicable law.

    A receipt can be printed after payment is accepted which may serve as evidence of payment. If an email address is provided during the payment process, a receipt will be emailed to you after the payment is processed.

    If for any reason you wish to make a change to the payment after submission, please contact Prairie Band Potawatomi Nation for assistance at 877.715.6789

  • $0.00
  • For Office Use Only

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