* Fields marked with an asterisk are required.


Account Type*:

Contact Information
( ) -
( ) -
( ) -
Mailing Address
If mailing address is outside the USA.
Service Address
If you check this box, you will not need to fill out the service address information below.
Payment Arrangement Details
Character limit: 500. To expand this field, click and drag the bottom right corner of the field.
Reason Unable to Pay*:

Reason Type*:I am unable to pay my full water and/or sewer bill due to:





If you selected Other, please explain below:
Character limit: 500. To expand this field, click and drag the bottom right corner of the field.
Payment Plan Requested*:A Payment Arrangement is a plan to pay the current bill charge plus the Previous Balance in Monthly Installments.



If you are requesting to establish a Payment Arrangement for the first time, please complete the following statement:
I am requesting that the Board of Water Supply (BWS) accept a Total Monthly Payment of
beginning
for
months.
Acknowledgements
Notification*:
Contact Information*:
Billing*:
To complete your request, enter your FULL LEGAL NAME.

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Posted: 05/14/2020