Water Billing Dispute Form

Water Billing Dispute Form
Date*

MonthDayYear
Date
Account Number*
Bill Number*
Name*

First NameLast Name
Service Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Reason for Dispute*
Example: "Disputing April, 2025 Billing Charges"
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Explanation*
Upload any document that is related to the dispute (e.g. pictures of meter,copy of bill, etc.)

Cancelof
Should be Empty: