Water and Sewer Adjustment Request

Customer Care
2791 East Point Street
East Point, GA 30344

Office: (404) 270-7010
Email: customercare@eastpointcity.org

*Please return this form via email, fax or mail to: Customer Care (see above).

Water & Sewer Adjustment Request

Water Leak Adjustment Policy

In cases when a utility bill is impacted by a water leak, a customer may qualify for an adjustment. Written proof (receipt, invoice, etc.), that the leak actually existed and that it has been repaired would need to be submitted to the Customer Care Department by the customer. The Department may require two (2) billing periods to monitor the consumption and to determine if an adjustment is due. The Department may verify that the repairs have indeed been made if the consumption has not returned to the average usage.

Adjustments due to water leaks will be handled according to the following:

*Within a twelve 12-month period.

I understand that it is my responsibility to furnish proof that the leak existed and that repairs have been made.
I have submitted a detailed description of the leak, location of the leak and actions taken to complete the repairs.
30- day hold placed on account once application is received.
Once adjustment is completed, a Payment Plan may be granted, if needed. 1/3 Down with up to 6-12 months.
By signing, I acknowledge the above.

Signature*

Date:*

MonthDayYear

Dear Customer Service Division,

We have received a high water bill for service at:

Name:*

(Full Name)

Account Number:

Telephone:*

Email:*

Service Address:*

Street Address

Street Address Line 2

CityState

Zip Code

Is the billing address the same as the service address?

YesNo

Billing Address:*

Street Address

Street Address Line 2

CityState

Zip Code

Date Leak Occured:*

MonthDayYear

Date of Repair(s):*

MonthDayYear

Type of Leak:

Underground PipeToiletOther

*Purchase / Plumber's Receipts must be included*

Purchase Receipt:*

Upload a File

Plumber's Receipt & Statement of Repair:*

Upload a File

Mission Statement
To provide exceptional city services in the most professional, courteous and effective manner to enhance the quality of life in the City of East Point.

FOR OFFICIAL USE ONLY

Date:

MonthDayYear

Cycle:

Customer Service Personnel: