Lynchburg, OH · Highland County
Pool Credit Form
Lynchburg customers use this form to request a sewer credit for water used to fill a pool at their service address.
What this form is
The form requests a sewer credit for water used to fill a pool. It asks for account and customer details, service address, pool dimensions and capacity, how full the pool was before filling, and the fill date. The form says all information must be completed and the request made within 30 days of filling the pool; credits are limited to one per household in a 12-consecutive-month period.
Who needs it
Lynchburg water customers seeking a sewer credit for filling a pool should complete this form with their account and pool information.
How to submit it
Submit it to the city department named on the form; check the city website for current contact details.
About notarization
This form is signed without a notary; it has no notarized attachment or sworn step, so the customer simply signs and dates it.
How to submit this form
- 1
Download The Form
Download the Pool Credit Form for a sewer credit request related to filling a pool.
- 2
Complete The Form
Fill in all requested account, customer, pool, and fill-date information.
- 3
Sign And Date
Sign and date the form and provide your phone number.
- 4
Submit To The City
Make the request within 30 days of filling the pool; check the city website for current submission details.
Frequently asked questions
- Do I need a notary for the Pool Credit Form?
- No. The customer signs and dates this form; it does not include a notarized attachment or sworn step.
- How do I submit the Pool Credit Form?
- The form does not give submission instructions. Submit it to the city department named on the form and check the city website for current contact details.
- When must I request a pool sewer credit?
- The form says the request must be made within 30 days of the date the pool is filled.
- What information does the form ask for?
- It asks for your account number, customer name, service address, pool dimensions and capacity, how full the pool was before filling, fill date, signature, date, and phone number.