Splendora, TX · Montgomery County
Leak Adjustment Form
Account holders use this form to ask the City of Splendora to reduce water bills because of a leak and provide repair details.
What this form is
This form asks the City of Splendora to reduce water bills for an account after a qualifying leak on the customer’s side of the meter. The responsible account party identifies the leak and repair dates, additional water-using appliances, leak type, and repair details, and attaches proof showing the repair date, address, type, and cost; faucet and hose leaks are ineligible.
Who needs it
The responsible party for a Splendora water account may submit this request after repairing an eligible leak on the customer’s side of the meter.
How to submit it
Complete and return the form to City of Splendora Utilities, P.O. Box 1087, Splendora, Texas 77372; include documentation of the repair date, address, type, and cost.
About notarization
This document is signed and dated without a notary; attach repair documentation, such as a plumber’s statement or bill, parts receipt, or qualifying employee statement.
How to submit this form
- 1
Download The Form
Download the Leak Adjustment Form PDF.
- 2
Complete The Request
Provide the account responsible party’s details, leak and repair dates, added water-using appliances, leak type, repair description, signature, and date.
- 3
Gather Repair Documentation
Attach documentation showing the repair date, address, type, and cost, such as a plumber’s statement or bill or a parts receipt.
- 4
Return It To Utilities
Send the form and attachments to City of Splendora Utilities, P.O. Box 1087, Splendora, Texas 77372.
Frequently asked questions
- Do I need a notary for the Leak Adjustment Form?
- No. The form calls for the requester’s signature and date, not a notary. Attach repair documentation; an in-house business statement must be signed by two employees who witnessed the repair.
- How do I submit the Leak Adjustment Form?
- Return the completed form to City of Splendora Utilities, P.O. Box 1087, Splendora, Texas 77372. Include documentation of the repair date, address, type, and cost.
- What repair documentation should I attach?
- The form accepts a plumber’s statement or bill, a receipt for parts, or, for businesses with in-house maintenance, a statement signed by two employees who witnessed the repair.