Request for Water Billing Adjustment
C
ity of Cibolo 200 South Main / PO BOX 826 Cibolo, Texas 78108 (210) 658-9900 www.cibolotx.gov
*We also reserve the right to make adjustments based on your historic usage.
*Please have copy of repair bill or receipts from purchase of items to repair leak attached.
Office Use: Approved Denied ____________________________________
Please read and acknowledge each item below by checking the box and signing:
____ Adjustments for unexplained high consumption will be considered when consumption exceeds
200% of historical usage.
____ Adjustments will be processed after evidence of repair is reflected by reduced consumption in the
following billing period.
____ The customer will be required to pay an amount equal to the most recent undisputed billed
amount by the due date, pending the adjustment calculation.
____ Adjustment calculation will consider customer average consumption for the same time period for
the prior two (2) years (or other relevant time period if that data doesn’t exist). Consumption in
excess of the average will be billed at a reduced rate of 50% of the residents average tier in the
applicable rate schedule.
____ Only one abatement will be granted in a 6 month period.
____ Adjustments under $25.00 will not be processed.
S
ignature: __________________________________________________
Name:
Date:
Address:
Contact #:
Location of Leak: ___ Inside
___ Outside
Account #:
Date of Repair:
Receipt Attached:
Describe Situation or Repairs Made:
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