Please enable JavaScript in your browser to complete this form.Name *FirstLastAccount Number *Did you receive a Leak Notification for PWC? *YesNoPhone *Email *Service Address *Address Line 1Address Line 2CityState / Province / RegionDescription of leak, location and any repairs made: *What date and time was the leak discovered? *DateTimeWhat date and time was the leak repaired? *DateTimeFile Upload * Drag & Drop Files, Choose Files to Upload Evidence must be uploaded here.Terms and Conditions The application must be submitted within 60 days of the billing period for active accounts, or within 30 days for closed accounts. Leak credit will not be processed for periods exceeding three (3) billing cycles. Accounts must be in good financial standing. An amount equal to the average monthly bill must be paid while the request is under review. The leak must have exceeded twice the average consumption. Only one leak credit may be awarded within any 12-month period. Leak credits are based on the volume of excess water usage, with specific percentage credits assigned accordingly. Approved leak credits will be applied directly to the account, and the account holder remains responsible for any remaining balance. Submitting this form does not guarantee a credit to the account holder. Signature * Clear Signature I confirm that I have read and understood the Terms & Conditions outlined above. I agree to provide accurate information and comply with all requirements for the leak credit application. I understand that approval is at the sole discretion of Provo Water Company Ltd.Date / Time *DateTimeSubmit
