CUSTOMER SERVICE FORMS

Submit a Billing Dispute


* Fields marked with an asterisk are required.


Billing Dispute Request Form Details

Enter today's date.

Account Type

Select if this a residential or non-residential account.

Service Holder Information

Enter the name of the business on this account.

Enter a prefix (optional).

Enter your first name.

Enter your middle initial (optional).

Enter your last name.

Enter a suffix (optional).

Enter a 10-digit cell phone number where we can contact you.

Enter a 10-digit phone number where we can contact you.

Enter a 10-digit phone number where we can contact you at the business.

Mailing Address

Enter the mailing address for the residence or business.

Enter the city for the residence or business.

Enter the state/province for the mailing address.

Enter the postal/zip code for the mailing address.

Enter the country/region for the mailing address.

Service Address

Check this box if the service address is the same as the mailing address.

Enter the service address for the residence or business.

Enter the city for the residence or business.

Enter the state for the residence or business. By default, this should be Hawaiʻi.

Enter the zip code for the residence or business.

Billing Dispute Details

Enter the water service account number for the residence or business.

Character limit: 500.

Character limit: 500.

Character limit: 500.

Character limit: 500.

Billing Dispute Request Form Submittal

To complete your request, enter your FULL LEGAL NAME.

Enter today's date.


Posted: 05/14/2020

< BACK TO CUSTOMER SERVICE REQUEST FORMS