Water Billing Dispute Form

Water Billing Dispute Form
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
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.Format: (000) 000-0000.
Explanation
Upload any document that is related to the dispute (e.g. pictures of meter,copy of bill, etc.)

Cancelof
This form is provided for the user’s convenience. Use and submission of this form is not the exclusive manner of appeal.
Should be Empty: