Here are links to forms that customers may find useful in doing business with HWPUD. All of these forms are also available at the District’s office. We can also mail forms to you, if needed.
Water Service Application – all new customers need to submit a copy of this form to apply for water service in HWPUD. We will need to see a photo ID. There is a $20 application fee that will be added to your first bill. These applications can be dropped off at the office, mailed to 87845 Hwy 101, Florence, OR 97439, faxed to us at 541-997-1059, or scanned and emailed to us at firstname.lastname@example.org
Water Leak Adjustment – Leaks happen! HWPUD has a Water Leak Adjustment policy. If you have a leak, find it and fix it, fill out this form completely, and return it to the office. The General Manager needs to approve a leak adjustment, which will be 50% of the leak. This is calculated by using your last year’s average usage. Someone from the office will call you and let you know how much the adjustment will be. You do not have to take the adjustment. We allow only one adjustment every two years.
Customer Assistance Program – The Board of Directors has passed a resolution (Resolution 2014-12) to help low-income customers with their water bills. Please read this form to see if you can qualify for this assistance.
ACH for Checking Accounts – we can arrange an automatic payment from your checking account after we receive this form from you along with a voided check. You will still receive a copy of the bill so that you will know how much water you used and how much we will be taking out of your account. We arrange that auto-pay to come out of your account around the 25th of the month, when the bill is due.
ACH for Credit Cards – If you would like to arrange for automatic payments through a credit card, fill out this form and turn it in to the office. You can mail (87845 Hwy 101 Florence, OR 97439) fax (541-997-1059) or drop it off at the office. You will still receive a bi-monthly paper bill, so that you know how much will be charged to your credit card on the 25th of the month, when the bill is due. We will honor all credit cards and debit cards, except American Express.