Sims, NC · Wilson County
Pool Adjustment Request
Residents use this form to request a utility bill adjustment after filling a pool and provide details about the fill and water meter used.
What this form is
The Pool Adjustment Request lets a resident ask for a utility bill adjustment after filling a pool; only sewer usage can be adjusted, and the resident remains responsible for all water used. The form asks for the resident’s name and address, pool-fill date, estimated gallons, and which meter was used. Submit the request before the first of the month after the pool fill; a bill that has been paid, even partially, cannot be adjusted.
Who needs it
A resident who wants to request an adjustment to the sewer portion of a utility bill after filling a pool should complete this form.
How to submit it
Submit it to the city department named on the form; check the city website for current contact details. The form does not list an address, email, or portal.
About notarization
This request is signed and dated without a notary; the resident and a town official sign and date the form.
How to submit this form
- 1
Download The Form
Download the Pool Adjustment Request form.
- 2
Complete The Request
Enter your name and address, pool-fill date, estimated gallons, and the meter used; then sign and date the form.
- 3
Gather Attachments
The form does not identify any attachments to gather.
- 4
Submit To The City
Submit it to the city department named on the form; check the city website for current contact details.
Frequently asked questions
- Do I need a notary for the Pool Adjustment Request?
- No. The form is signed and dated without a notary; both the resident and a town official sign and date it.
- How do I submit the Pool Adjustment Request?
- The form does not give a submission address, email, or portal. Submit it to the city department named on the form and check the city website for current contact details.
- What information does the Pool Adjustment Request ask for?
- It asks for the resident’s name and address, pool-fill date, estimated gallons used, and whether the house meter or yard meter was used.
- When must I submit a pool adjustment request?
- Submit the request before the first of the month following the pool fill. The form says a bill cannot be adjusted if its non-adjusted usage is billed and paid, even partially.