Your browser either does not support JavaScript or you have JavaScript disabled. Please enable JavaScript or view this page in
Text Version
.
Skip Navigation
This table is used for column layout.
Water & Sewer Billing Request Online Form
Printer-Friendly Version
Choose from the following:
Checkboxes
Checkbox Description
Checkboxes
Checkbox Description
Request for Leak Test
Request for Meter Re-Read
Request for Dye Strips
Payment Plan
Please provide the following information:
Field Description
Field Data
Required Field
Name:
required
Email:
required
Address:
required
City:
required
State:
required
Zip:
required
Phone:
required
Alt Phone:
required
Fax:
Organization:
Please enter your Account/Customer Number
For Dye Strips, please enter the number of bathrooms in your home.
For a Payment Plan, please enter the date that the balance will be paid in full. The date can be no longer than 30 days from the bill's original due date.
Field Description
Field Data
All payment plans must be approved by the Water Department in order to validate them. A confirmation email will be sent if the plan is approved. If you do not have an email account, please provide a contact phone number.
If payments are not made on date agreed upon, service will be disconnected without further notice and payment of the balance due must be made in full along with a restoration fee of $50.00.
All payments made toward this payment plan must be made at the O'Fallon City Hall; either in our office or the 24-Hour Drop Box located in the parking lot. There will be a penalty on any unpaid balance.
Clicking on the Send This Form Button below signifies that you understand and agree to the terms and conditions above.
City of O'Fallon, IL
255 South Lincoln, O'Fallon, IL 62269
Tel:
(618) 624-4500
Fax:
(618) 624-4508
City Hall Hours:
Monday - Friday, 8:00 am - 5:00 pm