Request For Leak Adjustment
Name
(Required)
First
Last
Address
(Required)
Street Address
Address Line 2
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Phone
(Required)
Account Number
(Required)
Request For Leak Adjustment
Request Amount
(Required)
25% Off
50% Off
Catastrophic
Date Of Leak
(Required)
MM slash DD slash YYYY
Address Of Leak
(Required)
Street Address
Address Line 2
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Supporting Documents
(Required)
Drop files here or
Select files
Accepted file types: jpg, png, pdf, heic, Max. file size: 499 MB, Max. files: 5.
Upload receipts and/or pictures of repaired leak.
Leak Adjustment Policy
(Required)
To qualify for relief from large leaks, the usage must be at least twice the customer’s 12-month average bill. Once RSUD notifies customers of high usage, customers have five (5) business days to provide acceptable proof of repair, which would include plumber receipt, parts receipts or photographic evidence. Once receipt or photo is received by RSUD, we will get an updated reading to be applied to the entire leak adjustment. If proof of leak HAS NOT been received by RSUD within the five (5) business days the customer forfeits relief. **This is to cut down on the leak rolling over into multiple billing cycles**
1st occurrence in a 2-year period. Take a 12-month average usage plus the minimum bill (or as long as the account has been active if less than 12 months) and 50% of the usage over the average. Payments can be made over time if necessary.
2nd occurrence in a 2-year period. Take a 12-month average usage plus the minimum bill (or as long as the account has been active if less than 12 months) and 75% of the usage over the average. Payments can be made over time if necessary.
In the event of a catastrophic leak, where the consumption is 20 times the customer’s average bill, the customer will pay the minimum bill plus a 12-month average (or as long as the account has been active if less than 12 months).
In the event of a 2nd catastrophic leak, within a 2-year period, customer must appear before the Board for approval of any relief.
I understand.
Signature Of Applicant
(Required)
Use your finger or mouse to sign this agreement. Please note that electronic signatures are binding.
Scroll to Top