Freeport, TX · Brazoria County
Adjustment Request Form
Freeport Utilities customers use this form to request a one-time high bill or pool/sewer adjustment, or removal of specified late or cutoff fees.
What this form is
The City of Freeport Utilities Adjustment Request Form lets a customer request a one-time high bill adjustment, a pool/sewer adjustment, or removal of a 10% late fee or $40 cutoff fee. The form states that all adjustments are allowed only once per calendar year. It asks for the account number, service address, customer name, date, requested adjustment, signature, and callback number.
Who needs it
A Freeport Utilities customer requesting one of the listed bill adjustments or fee removals should complete and sign this form.
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 and dated without a notary; it lists no notarized or sworn attachment, so the customer simply signs and dates it.
How to submit this form
- 1
Download The Form
Download the Freeport Utilities Adjustment Request Form.
- 2
Complete The Form
Enter your account number, service address, customer name, date, requested adjustment, and callback number.
- 3
Sign And Date
Sign the acknowledgement certifying that the information provided is accurate.
- 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
- What adjustments can I request on the Freeport Adjustment Request Form?
- The form lists a one-time high bill adjustment, a pool/sewer adjustment, removal of a 10% late fee, and removal of a $40 cutoff fee.
- Do I need a notary for the Freeport Adjustment Request Form?
- No. The customer signs and dates this form without a notary. It lists no notarized or sworn attachment.
- How do I submit the Freeport Adjustment Request Form?
- Submit it to the city department named on the form; check the city website for current contact details.
- How often are adjustments allowed?
- The form states that all adjustments are allowed only once per calendar year.