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Adjustment Request Form

  1. Adjustment Request Form

    320 Alexandria Boulevard
    Oviedo, FL 32765
    Phone: 407-971-5535
    Fax: 407-971-5806

    Office Hours:
    8 a.m. until 5 p.m.

  2. Instructions

    MUST INCLUDE RECEIPT (without a receipt for repairs, your adjustment may not be approved).
    PLEASE NOTE: PER CITY ORDINANCE 54-2 - Utility Customer over the previous 12 months before the accident must have an average usage of no greater than 1.5 times their allotted water capacity.
    - Utility Customer must have been unaware, unknowing and / or did not have direct action to cause the accidents that lead to larger water consumption.
    - The flow resulting from the mishap must be greater than two times the previous 12 months average consumption.
    - Utility Customer MUST provide evidence that the condition and / or cause of the accident have been corrected.
    - Utility Customer shall have a minimum six months usage at the address of the mishap to be eligible for relief.
    - Utility Customer shall be limited to one (1) request every 24 months.
    - If the Utility Customer’s account is less than 12 months, three of the highest months will be used to calculate an average.

  3. MUST INCLUDE RECEIPT (without a receipt for repairs, your adjustment may not be approved).

  4. Electronic Signature Agreement*

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

  5. The City of Oviedo does not accept liability for transmission of this form with confidential information. Email over the internet is NOT a secure medium and privacy cannot be assured.

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  7. This field is not part of the form submission.