CUSTOMER SERVICE FORMS

Submit a Billing Dispute

* Fields marked with an asterisk are required.

Date of Request

Account Type

Residential

Non-Residential

Service Holder Information

Business Name

Prefix

First Name

Middle Initial

Last Name

Suffix

Cell Phone

Home Phone

Business Phone

Mailing Address

Street Address

City

State/Province

Postal/Zip Code

Country/Region

Service Address

Same as the Mailing Address

Street Address

City

State

Zip Code

Billing Dispute Details

BWS Account Number

Bill Date(s) in Dispute

Character limit: 500.

Amount(s) in Dispute

Character limit: 500.

Reason for the Billing Dispute

Character limit: 500.

Specific Adjustments to the Bill You Are Requesting

Character limit: 500.

Requester Name

To complete your request, enter your FULL LEGAL NAME.

Submission Date

Posted: 05/14/2020

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CUSTOMER SERVICE FORMS

Submit a Billing Dispute