Departments » Water Billing

Billing Adjustment Request Form

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Please correct the fields below:

1
Today's Date
 *
2
Account Number
 *
3
Service Address
 *

Qualifications:

  • The account must be active for:
    • At least 12 months of consumption history prior to the leak.
    • At least 6 months of consumption history (if the account is new) prior to the leak.
    • 6 to 12 months of recent consumption at their previous similar Pearland water account. 
  • Uploaded proof of repair is required. Acceptable proof: plumber’s receipt(s), receipt of repair items purchased, written narrative of repair from preexisting items.
  • Billed leak monthly usage is 3x the account’s recent average 12-month usage.
  • For a high-volume adjustment, billed monthly usage must be 20,000 gallons or greater.
4

Preferred Adjustment:

Preferred Adjustment:
*If billed leak monthly usage does NOT qualify for the High Volume Adjustment, but instead qualifies for a regular adjustment, Staff will process a regular adjustment.

City provides for "Regular" and "High Volume" Adjustments

  • Regular Adjustment: Adjust impacted service(s) 40% of the qualified bill(s). Once the adjustment(s) are applied to the account, no other adjustments will be applied for 12 months.
  • High Volume Adjustment: Adjust qualified bills to the customer's 12 month average. Once the adjustment(s) are applied to the account, no other adjustment will be applied for 24 months.

***Please read and initial the following statements***

5
I understand that submission of this request does not automatically qualify my account for an adjustment.
 *
6
I understand that during the review process of my billing adjustment request, I am responsible to pay or make payment arrangements regarding the amount due.
 *
7

I understand that billing adjustment requests may take up to two billing cycles to be completed, depending on when my consumption returns to its average usage.

 *
8
Customer Name
 *
9
Customer Signature
 *
10
Customer Phone Number
 *
11
Customer Email:

Email proof of repair or receipt.

If you are unable to upload proof of repair, please visit our office at 3523 Liberty Drive.

  1. To receive a copy of your submission, please fill out your email address below and submit.