2. Is a water leak adjustment right for me?

   Please visit the Water Leak Adjustment Page for more details.

4. Customer Number*
5. Account Number*
7. Service Address*
8. Service Address*
10. Requested By*
11. Phone Number*
13. Email Address*
15. Bill Date(s) Affected*
16. Date Leak was Fixed*
18. Description of Leak (Toilet, Underground, etc.)*
20. I have read the City of Edmond Water Leak Adjustment Policy and agree no further water issues are on the property at this time.*

    1. I agree
22. Please Note:

    Completion of a request does not guarantee an adjustment will be made to your bill. All requests are evaluated using the criteria outlined in the Water Leak Adjustment Policy.

24. Attachments:

    Please upload any relevant attachments here.

Leave This Blank:


26. 1. Receive an email copy of this form.
27. Email address

    This field is not part of the form submission.

28. Submit

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