Customer Assistance Application
Water Revenue Bureau

• Completing the online application could take up to an hour. You will have an opportunity to save your progress and return to this application later if you provide a correct email address when prompted to do so. To complete your application, you will need to upload supporting documents, which may need to be scanned first. You will not be able to submit your application without uploading supporting documents.
  The application requires you to upload:
  

  
  
  • proof of residency,
  • proof of income for yourself and other household members, and
  • proof of hardship, if applicable.

  
  For more information visit the instructions page.
  
  If instead you wish to fill out a paper application and attach hard copies of supporting documents, click Cancel below to return to the previous page and select Print Now or Mail Me an Application.

If you start over, all the information entered and any documents you saved will be deleted. Starting over will not delay a scheduled shut off. If you are in danger of shut off, please call our Contact Center at 215-685-6300. Are you sure that you want to start over?

• Completing the online application could take up to an hour. You will have an opportunity to save your progress and return to this application later if you provide a correct email address when prompted to do so. To complete your application, you will need to upload supporting documents, which may need to be scanned first. You will not be able to submit your application without uploading supporting documents.
  The application requires you to upload:
  

  
  
  • proof of residency,
  • proof of income for yourself and other household members, and
  • proof of hardship, if applicable.

  
  For more information visit the instructions page.
  
  If instead you wish to fill out a paper application and attach hard copies of supporting documents, click Cancel below to return to the previous page and select Print Now or Mail Me an Application.