Water Billing Dispute Form
Date
*
-
Month
-
Day
Year
Date
Account Number
*
Bill Number
*
Name
*
First Name
Last Name
Service Address
*
Street Address
Street Address Line 2
City
State / 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.
Format: (000) 000-0000.
Explanation
*
Upload any document that is related to the dispute (e.g. pictures of meter,copy of bill, etc.)
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