The City of Pasadena Discounted Rates Program provides reduced rates on water, sewer and garbage
services to customers that are sixty-five (65) or older. To be eligible for the discounted rates, the applicant
must reside in the residence where the discount is being requested. In addition, the customer’s water
account must be in the applicant’s name. A copy of one of the following is needed for eligibility: (a) Texas
Driver’s License; (b) Texas Department of Public Safety Identification; (c) Birth Certification; or (d) Other –
must state date of birth. Note: Application will not be processed unless you provide the required
documentation.
Water Account Number: ____________________________
Service Address: ___________________________________________
Customer Name: __________________________________________
License/ID #: _______________________________
Date of Birth: _______________________________
Contact #: _________________________________
Email Address (Optional):
____________________________________________________
____
________________________________________ __________________________
Customer’s Signature Date
City of Pasadena -Water Billing
P.O. Box 1337
Pasadena, TX 77501-1337
713.475.5566 – Office
713.475.4945 – Fax
wbcs@pasadenatx.gov
APPLICATION FOR DISCOUNTED RATES
FOR OFFICE USE ONLY:
Received ________________ (Date in Office)
Employee Initials __________
Entered Into System ____________ (Date)
NOTE:
The preferred method of receiving this form is to deliver it in person to our
office. Although, we will accept a scanned and emailed, faxed or mailed version
of this form, you are responsible for contacting the Water Billing Office to
ensure receipt of your application.
click to sign
signature
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