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2. Department of Water Management
4. Payment Plan Agreement for Residential Customers
6. Through this Payment Plan for residential water customers, you can break up the total amount owed on your account into smaller payments that will appear on your bill as equal monthly installments. For example, if your account balance is $300, a six-month Payment Plan would allow you to spread that out as an additional $50 per month, added to your regular balance, until the total amount is paid.
8. After you submit this agreement, we'll contact you (usually within one or two business days) with information about your personal monthly payment amount.
10. Questions? Contact us at Customer Billing Services at 919-560-1200 (select option 2).
14. Account Identity
16. Account Number
    Enter your account number as it appears on your bill.
18. Contact Information
20. First Name
21. Last Name
23. Service Address
25. Primary Phone Number
26. Email Address
30. Select a Payment Plan

    1. 3 month plan
    2. 6 month plan
    3. 9 month plan (maximum)
    4. Other (fill in box below)
32. Ir you selected "Other" please provide your requested time frame and proposed payment amounts.
34. If you feel you need a longer period of time to make payments, please contact our Customer Billing Services department at 919-560-1200 (select option 2).
38. I acknowledge this Payment Plan Agreement does not eliminate my obligation to pay my full account balance. As the undersigned residential water customer, I remain legally responsible for paying the account balance in full. Failing to make the minimum payment plan amount as determined by this agreement constitutes a late payment and I understand my water will be disconnected the next day unless I contact the Department of Water Management before the payment date. By signing electronically, I acknowledge that failure to make the minimum payment on the due date will result in water and sewer service for this account being subject to disconnection.
40. *I have read the agreement and understand the terms.
42. *eSignature
Leave This Blank:


44. 1. Receive an email copy of this form.
45. Email address

    This field is not part of the form submission.

46. Submit

* indicates a required field