WATER SERVICE BY TRUCK APPLICATION

APPLICATION FOR WATER SERVICE BY TRUCK

MUNICIPAL AUTHORITY OF WASHINGTON TOWNSHIP

**Please contact the office to complete the application/service process.

This Credit Deposit Application for Water Service by Truck is subject to the Rules and Regulations established by the Municipal Authority of Washington Township. A deposit in the amount of One Hundred Dollars ($ 250.00 ) is required with this application, payable via check or money order to MAWT or pay online after submission of this form.

By signing this application, you agree to protect the meter from freezing or rough usage, and that you will be responsible for all charges incurred at this address.

Bills are issued monthly and are determined by meter registration. Minimum charge for water service is $218.00. A 2,000 gallon usage allowance is included in the monthly charge. Any usage over 2,000 gallons will be billed at $5.46 per 1,000 gallons. Bills are mailed the first week of the month and due the last Tuesday of the month, after which a 5% penalty is assessed. If the balance remains unpaid after 10 additional days, a delinquent notice will be sent with a water shut-off date if the account remains unpaid. You will be billed for any charges connected with collecting unpaid bills, including a $25 posting fee if your property is posted for shut-off. If a check is returned for insufficient funds, a $45.00 fee will be added to the account. If water is shut off for a delinquent account, a $ 50.00 fee will be added to the account.

If service is to be discontinued at this service location, the Authority is to be notified and arrangements made for the proper termination of service within 5 days. Failure to notify the Authority will necessitate additional charges on this account. $1.00/month capital improvement fee is added to every customer’s bill

Please Check One:

Owner Applicant

Applicant Name

Service Address

Water Plant Other Service Address

Other Service Address

Address where bills are to sent

HOME Phone#

Work Phone#

Cell Phone#

Business Name

Business Address

Business Phone#

Account number if known

Driver license number

State License issued

I Accept

I hereby acknowledge that the above information is correct and that I agree to use the sewer according to the Rules and Regulations of the Authority, and to pay for sewer service at the above service location.

TYPE YOUR NAME HERE

date

how are paying your security deposit?

ANY OTHER INFO you would like to tell us?

IMPORTANT: When you click the SEND button below, you will be taken to our secure payment page. If you want to pay online, choose the SECURITY DEPOSIT drop-down and follow the instructions for payment.

PLEASE BE SURE TO INCLUDE YOUR ACCOUNT NUMBER OR SERVICE ADDRESS IN THE REFERENCE FIELD WHEN PROCESSING YOUR PAYMENT.

** BE AWARE OF PROCESSING FEE– YOU WILL BE ABLE TO SEE THE FEE BEFORE ALLOWING PAYMENT TO PROCESS — As of October 1, 2016 the convenience fee is 2.65%. The minimum fee is $3.00.

***DO NOT USE ANY DASHES, SLASHES OR PERIODS IN THE EXPIRATION DATE, CARD NUMBER OR PHONE NUMBER– IT WILL NOT ACCEPT IF YOU DO.

E-Check is also a payment option–this service is a flat $1.50 service fee — please be aware—E-checks are not resubmitted– should the funds not be available the first time it is presented– it will not be reprocessed and you will incur a NSF charge from both MuniciPay and the Authority.

If you prefer to pay via check or money order, you can drop a check or money order off at our office or mail to:
Municipal Authority of Washington Township
1390 Fayette Ave
Belle Vernon PA 15012