WATER LEAK ADJUSTMENT FORM - Gulfport-MS.gov - gulfport-ms 2026

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The document is a Water Leak Adjustment Form that customers must fill out to request an adjustment on their water bill due to a leak. It requires personal information, details about the leak and repairs, and emphasizes the importance of continuing to pay average monthly charges to avoid service disconnection. The form also notes that adjustments may take time and outlines the customer's responsibility for past due balances.

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Click ‘Get Form’ to open the WATER LEAK ADJUSTMENT FORM in the editor.
Begin by entering the cycle and book number at the top of the form. This information helps identify your account.
Fill in the date you are submitting the form, along with your name, address, account number, and customer number. Ensure all details are accurate for a smooth processing experience.
Provide your telephone number for any follow-up communications regarding your adjustment request.
Indicate the date when the leak was repaired. This is crucial for processing your adjustment.
Attach any documents related to repairs made or write a brief description of those repairs in the designated area.
Sign and date the form at the bottom to confirm that all information provided is correct and complete.

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