COBB COUNTY WATER SYSTEM
Customer Services Facility
660 South Cobb Drive
Marietta, Georgia 30060-3105
(770) 419-6200 Fax (770) 419-6224
I, a resident of Cobb County, do hereby apply for the Senior Citizens' Discount
offered by the Cobb County Water System.
I understand that the Senior Citizens' Discount exempts me from payment of 100%
of the monthly service charge applied to monthly water bill.
To qualify for this discount, I declare the following to be true and accurate to the best
of my knowledge.
1. I am sixty-five (65) years of age or older.
2. My total annual combined household income does not exceed $15,930.00.
Note: This Senior Citizens' Discount is valid through September 30 of
each year. In September a verification form will be mailed to each
customer who is participating in the discount program. The verification
form must be signed, witnessed, and returned to the Water System
before the end of September in order for the customer to continue this
program.
Customer Signature Witness
Date Account Number
SENIOR CITIZENS' DISCOUNT
QUALIFICATION AFFIDAVIT
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Equal Opportunity Employer
Cobb County...Expect the Best!
www.cobbwater.org
Email: WaterCustomerService@cobbcounty.org
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