Sachse, TX · Dallas County
Repair Adjustment Request
Customers use this form to request a utility account adjustment for eligible water consumption related to a leak or pool refill after repairs.
What this form is
This form lets a customer request a utility account adjustment for eligible water consumption related to a leak or pool refill after repairs. The city considers requests case by case, and completing the form does not guarantee eligibility. It asks for account and contact details, repair dates and a description, and requires repair documentation. Submit the request within 90 days after the repair.
Who needs it
A customer seeking a utility account adjustment for eligible water consumption after repairing a leak or completing a pool refill should file 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 without a notary; include repair documentation, and the signer simply signs and dates the form.
How to submit this form
- 1
Download the Form
Download the Repair Adjustment Request form.
- 2
Complete the Form
Enter the account and contact details, repair dates, and a brief description of the repairs.
- 3
Gather Repair Documentation
Attach proof of repair, such as an itemized receipt, plumber invoice, pool technician receipt, or other supporting documentation.
- 4
Submit to the City
Submit the form and documentation to the city department named on the form within 90 days after the repair.
Frequently asked questions
- Do I need a notary for the Repair Adjustment Request?
- No. The form is signed and dated without a notary. Include repair documentation, such as an itemized receipt, plumber invoice, or other supporting documentation.
- How do I submit the Repair Adjustment Request?
- Submit the form with repair documentation to the city department named on the form. Check the city website for current contact details.
- What repair documentation should I include?
- The form says proof of repair is required. Acceptable examples include an itemized receipt for repair parts, a plumber invoice, a pool technician receipt, or other documentation supporting the repairs.
- When must I submit the request?
- Submit the form with repair documentation within 90 days after the repair date for consideration. The form says adjustments cannot cover a period greater than 90 days.
Need something notarized?
This Repair Adjustment Request doesn’t need a notary — but Texas residents can notarize other documents online with a commissioned online notary.