Skip to form

City of Whitehouse

water@whitehousetx.org

101 A Bascom Road - PO Box 776 Whitehouse, TX 75791

(903) 510-7500

image

Leak Adjustment Form

A leak or unintended consumption on the customer's side of the meter is considered a private matter and is the responsibility of the property owner to repair. However, the City of Whitehouse offers a leak adjustment as a courtesy to our customers who qualify. This adjustment will be granted no more than once every 24 months for leaks and no more than once every 36 months for unintended consumption. Per City Leaks and Unintended Consumption Adjustment Policy, the City will charge the customer based on the twelve-month average monthly bill immediately preceding the leak. 

In order to be eligible for this adjustment you must submit this form along with your receipt for plumbing repairs or other documentation to show that a leak was present and has been repaired.

Full Name

Service Address

Copy of Plumbing Bill or Receipt

Click Here to Upload

I, the undersigned, experienced a leak or unintended consumption at the above service address that resulted in my water consumption being 50% higher than my normal water consumption. I have had the leak repaired, as evidenced by the attached receipt, and am requesting an adjustment to my account. 

I understand that this request will not be considered until after the meter is read for the period following the leak or unintended consumption repair. Further, I understand that only the two highest months effected by the leak will be adjusted and that I must make payments on my account equivalent to my normal monthly bill for months effected by the leak and must pay all current monthly charges once the leak has been repaired regardless of whether or not an adjustment has been granted. 

Customer Signature

Choose how to sign