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Courtesy Leak Adjustment Request Form 2026

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The document outlines the Courtesy Leak Adjustment Request Form and the associated policy from Utilities, Inc. for residential customers seeking adjustments to their water bills due to excessive consumption caused by leaks. It details customer responsibilities, criteria for eligibility, and the adjustment procedure, emphasizing that adjustments are not guaranteed and must meet specific conditions such as significant leaks and timely submission.

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Click ‘Get Form’ to open the Courtesy Leak Adjustment Request Form in the editor.
Begin by filling in your Customer Information. Enter your Name on Account, Account Number, Service Address, and Contact Phone Number in the designated fields.
In the Leak Repair Information section, provide the Date Leak Discovered and indicate whether it was Professionally Repaired or Self Repaired. Include the Date Leak Repaired if applicable.
Describe the leak and repair in detail. This is crucial for validating your request. Attach any necessary documentation, such as a plumber’s bill or receipts for materials purchased.
Finally, sign and date the form at the bottom before submitting it to ensure all information is complete and accurate.

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2018	4.8 Satisfied (60 Votes)

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Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

How much would my water bill go up if I had a leak?

Spending a few extra cents each month shouldnt have any sort of noticeable impact on your finances. Bigger leaks, however, can be a lot more expensive. A running toilet can waste up to 8 gallons of water an hour and about 200 gallons a day! That could add up to about 6,000 gallons a month if it goes unnoticed.

Do I have to pay the water bill if there was a leak?

Many utilities offer refunds To recover one-time water losses, contact the agencys customer service department or fill out a form on the agencys website. Proof of repair must be submitted (a plumbers bill or receipts for parts purchased by the homeowner) or some municipalities use meter readings.

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