Get the free Leak Adjustment Request Form - City of Lacey
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Leak Adjustment Request Form Submittal of this form does not guarantee that a leak adjustment credit will be granted. A leak adjustment will be allowed under the following circumstances: 1. 2. 3.
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How to fill out leak adjustment request form
How to fill out leak adjustment request form
01
To fill out a leak adjustment request form, follow these steps:
02
Obtain the leak adjustment request form from the concerned department or website.
03
Provide your personal information such as name, address, contact number, and account number.
04
Specify the date when the leak occurred and provide a brief description of the leak.
05
Attach any supporting documentation or evidence of the leak, such as photographs, bills, or repair receipts.
06
Calculate the estimated amount of water that was leaked and the corresponding cost.
07
Clearly explain the reason for requesting the adjustment and how it was beyond your control.
08
Sign and date the form.
09
Submit the completed form to the appropriate department via mail, email, or in-person.
10
Keep a copy of the form for your records.
11
Follow up with the department to ensure your request is being processed.
Who needs leak adjustment request form?
01
Anyone who has experienced a water leak and wants to request an adjustment on their water bill needs the leak adjustment request form.
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What is leak adjustment request form?
The leak adjustment request form is a document used to request an adjustment in the event of a leak affecting utility bills.
Who is required to file leak adjustment request form?
Any customer who has experienced a leak and believes it has impacted their utility bills is required to file a leak adjustment request form.
How to fill out leak adjustment request form?
To fill out the leak adjustment request form, customers must provide information about the leak, the amount of water wasted, and any documentation supporting the claim.
What is the purpose of leak adjustment request form?
The purpose of the leak adjustment request form is to provide customers with an opportunity to request an adjustment to their utility bills due to a leak.
What information must be reported on leak adjustment request form?
Information such as the date and location of the leak, the amount of water wasted, and any supporting documentation must be reported on the leak adjustment request form.
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