Appeal Form
Your Name
*
First Name
Last Name
Name on DWA water account
*
Same as above
Other
I am not an account holder
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email address
example@example.com
Property Address
*
Service Address
Service Address Line 2
City
State / Province
Postal / Zip Code
Date of the bill or decision you are appealing
*
/
Month
/
Day
Year
Name on DWA Account
Why are you appealing your bill or DWA's decision?
*
What would you like DWA to do?
Reverse a late fee
Reverse another charge or citation
Credit/discount my bill
Grant me a rebate
Grant me a rebate in a different amount
Other
Please let us know what you'd like DWA to do.
Please upload any supporting documents or photos.
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