Buellton, CA · Santa Barbara County
Utility Bill Appeal Form
Buellton utility customers use this form to ask the city to review disputed water or sewer billing charges.
What this form is
The form lets an account holder explain why water or sewer bill charges are disputed and request review by the Finance Director. The city says to contact it before the payment due date; if the investigation does not resolve the issue, a completed appeal form may be submitted within 30 days of the disputed bill’s issue date. It asks for account details, the bill date, appeal amount, grounds for appeal, and a signature.
Who needs it
An account holder disputing water or sewer charges may use this form to request review after contacting Customer Service.
How to submit it
Submit the completed form within 30 days of the disputed bill’s issue date to the Finance Director, City of Buellton, PO Box 1819, Buellton, CA 93427-1819. The form also lists fax 805-686-0086 and [email protected].
About notarization
This form is signed and dated without a notary; attach supporting sheets or documentation, and include required sewer-break documentation when applicable.
How to submit this form
- 1
Download The Form
Download the Utility Bill Appeal Form.
- 2
Complete The Form
Fill in the account and appeal information, explain the disputed charges, then sign and date the form.
- 3
Gather Supporting Documents
Attach any additional sheets or documentation; include the listed sewer-break documents when requesting a sewer quantity review.
- 4
Submit To The Finance Director
Send the completed form within 30 days of the disputed bill’s issue date by mail, fax, or email using the form’s listed details.
Frequently asked questions
- Do I need a notary for the Utility Bill Appeal Form?
- No. The form is signed and dated without a notary. Attach supporting sheets or documentation, and include required sewer-break documentation when applicable.
- How do I submit the Utility Bill Appeal Form?
- Submit it within 30 days of the disputed bill’s issue date to the Finance Director by mail, fax, or email using the contact details on the form.
- What information does the appeal form request?
- It asks for the account holder’s name, account number, contact details, service address, bill date, appeal amount, grounds for the appeal, and signature.
- What documentation is needed for a sewer quantity review?
- For a qualifying water break that did not drain into the sanitary sewer, the document says to provide the occurrence date, repair invoice, photos of the damaged device, and an attestation.