Form Center

By signing in or creating an account, some fields will auto-populate with your information.

Utility Adjustment Request

  1. Utility Adjustment Request Form
  2. Must be completed by the account holder
  3. Customers of the City of Casselberry may request an adjustment on the current water bill if they have recently encountered a leak, pool fill, or unexplained/unintended usage by completing and submitting this application.

    As a customer of City of Casselberry Utilities Division, a customer may request an adjustment to the current water bill if they have recently encountered double the usage of consumption due to a leak, pool fill or new sod in a 12-month period or unexplained/unintended usage once in a 3-year period. The adjustment request must be submitted within 90 days from the bill date including valid proof of repair and 30 days from bill date for unexplained/unintended use. The submittal of this request does not prevent the account from collection activity, including service interruption. Please refer to the adjustment ordinance 18-1499 and/or adjustment policy for full details.

    Please contact Utility Customer Service at (407) 262-7760 for further details.

  4. VALID PROOF OF REPAIR MUST BE SUBMITTED BELOW
  5. Under Florida law, e-mail addresses are public records.
  6. Please select reason for the adjustment request*
  7. Invoice, Receipt, Pictures, etc.
  8. Please allow 10 business days for processing
  9. Acknowledgement

    By submitting this application, I have read and understand the adjustment policy. (I also understand my responsibility of any balance on the account after the adjustment has been applied must be paid or my account will be subject to interruption of service and/or report to the collection agency.)

    I certify that the above information is true to the best of my knowledge.

  10. Signature
  11. Submit
    Completed forms may be printed and mailed to P.O. Box 180819, Casselberry, FL 32718-0819 or delivered in person at 95 Triplet Lake Drive, Casselberry, FL 32707
  12. Email Notice

    Under Florida law, e-mail addresses are public records. If you do not want your e-mail address released in response to a public-records request, do not send electronic mail to this entity. Instead, contact this office by phone or in writing.

  13. Leave This Blank: