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2. Is a water leak adjustment right for me?

   Please visit https://www.nnva.gov/2415/Water-Leak-Adjustment-Policy for more details.

4. Account Number*
6. Service Address
8. House No.*
9. Street Name*
11. City/County*
    -- Select One --HamptonJames City CountyNewport NewsPoquosonYork
12. State*
    -- Select One --Virginia
14. Zip Code*
16. Requested By*
17. Phone*
19. Email*
21. Bill Date(s) Affected*
23. Description of Leak (Toilet, Underground, etc.)*
25. Date Leak was Fixed*
    Date Leak was Fixed
27. I have read the Newport News Waterworks Leak Adjustment Policy, including that I will receive no more than one leak adjustment per premise per 12 months.*

    1. I agree
29. Please Note

    Completion of a request does not guarantee an adjustment will be made to your bill. All requests are evaluated using the criteria outlined in the Waterworks Water Bill Adjustment Policy.

31. Attach copy of last bill (if available):
33. Attachment 2
Leave This Blank:


35. 1. Receive an email copy of this form.
36. Email address

    This field is not part of the form submission.

37. Submit Submit and Print

* indicates a required field