Virden, IL · Macoupin County
Hearing Request Form
Virden residents use this form to request a hearing about a disputed water bill and provide the reason for disputing the charge.
What this form is
The form requests a hearing for a disputed water bill; it is not for payment plans or matters unrelated to water service charges. The resident provides the property address, date, daytime phone number, and reason for the request, then confirms the information is true and correct by signing and dating it. The city section records the hearing date, findings, and resolution.
Who needs it
A Virden resident disputing a water bill can complete this form to request a hearing about the charge.
How to submit it
Complete the residents’ portion and return the form to the City address, attention Water Department. The form does not provide a street address.
About notarization
This document is signed without a notary; the resident signs and dates the request.
How to submit this form
- 1
Download The Form
Download the Virden Hearing Request Form PDF.
- 2
Complete The Residents’ Portion
Enter the property address, date, daytime phone number, and reason for requesting a hearing.
- 3
Sign And Date
Sign and date the request to confirm the information is true and correct.
- 4
Return The Form
Return the completed form to the City address, attention Water Department.
Frequently asked questions
- Who can use the Virden Hearing Request Form?
- The form is for residents requesting a hearing about a disputed water bill. It is not for payment plans or matters unrelated to water service charges.
- What information does the form ask for?
- It asks for the property address, date, daytime phone number, and reason for the request. The resident signs and dates a statement confirming the facts are true and correct.
- Do I need a notary for the Hearing Request Form?
- No. This document is signed without a notary; the resident signs and dates the request.
- How do I submit the Hearing Request Form?
- Complete the top portion and return it to the City address, attention Water Department. The form does not provide a street address.