Dispute Form
Your Name
*
First Name
Last Name
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
What are you disputing?
*
Please Select
Billing, fees or taxes
Meter read or high bill
Water waste citation
Conservation program
Construction issue
Development issue
Other
Date of the bill or decision you are disputing
*
-
Month
-
Day
Year
Disputes are applicable for bills and decisions rendered within the past 10 business days.
Name on DWA water account
*
Same as above
Other
I am not an account holder
Name on the DWA account in question
Details to review
*
Do you have supporting documents or photos to upload?
*
Yes
No
Please upload any supporting documents or photos.
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