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2. Per West U's Code of Ordinances Sec. 86-37. (b)
   Unusually large bill. A residential user may request an adjustment to a bill for water and sewer services that is greater than 160 percent of average water usage. The reason for the adjustment must not be a leak or new equipment or facilities that use water. If these conditions are met, the user's water and sewer bill may be recalculated using 160 percent of average water usage.
4. Adjustment Process:
   The adjustment will be calculated using average water usage, which will be the last (12) months prior to the leak, but not less than (3) months. We will only process one high month out of the last (6) consecutive months that have already been billed from the time you submit the adjustment request. If there are multiple high months, we will use the highest month.
   
   To request this adjustment, complete and submit this form.
6. Service Address:*

   City, state, and zip not required

8. Name on the Utility Account:*
10. Period in Question:*

    This will be the highest month you are requesting the adjustment for out of the last (6) consecutive months that have already been billed.

12. Reason for Requested Adjustment:*

    I am requesting a reduction in the utility bill from the City of West University because of an unusually large bill at the property above.

    
    

    Please check all of the below:

    1. I have completed the above information
    2. I have not had any plumbing repairs or used substantially more water during the billing period.
    3. I understand that any adjustment will be forthcoming on the next billing.
    4. I also understand I will not be eligible for another adjustment for at least (12) months.
14. Electronic Signature:*

    By typing your name into this field, you understand that the information given above will be used in processing your adjustment request. You are agreeing that the information given to the City is correct.

15. Date:*
    Date:
17. Email:*
18. Best Phone #:*
Leave This Blank:


20. 1. Receive an email copy of this form.
21. Email address

    This field is not part of the form submission.

22. Submit

* indicates a required field