Application for Service - Tenants

This application is to initiate a new water/wastewater/stormwater service(s) account.  The tenant applicant whose name appears below requests water/wastewater/stormwater service(s) for the address below and agrees to receive and pay for such service(s) in accordance with The Pittsburgh Water and Sewer Authority’s Tariffs as filed with the Pennsylvania Public Utility Commission, which are now in effect or will become effective in the future.  Proof of tenancy is required with this application.  Incomplete forms may delay the application process. 

If you are a tenant in a multi-unit residential dwelling facing termination due to your landlord's non-payment, you have the right to maintain service. For more information about your rights, please review our Rights of Tenants in Multi-Unit Residential Dwellings flyer. 

*Required Fields
Tenant Contact Information
*Service Address
Mailing Address (if different)
Tenant Submissions
*Reason for Change
*Proof of Tenancy Included
One file only.
100 MB limit.
Allowed types: gif, jpg, png, bmp, eps, tif, pict, psd, txt, rtf, html, odf, pdf, doc, docx, ppt, pptx, xls, xlsx, xml, avi, mov, mp3, ogg, wav, bz2, dmg, gz, jar, rar, sit, svg, tar, zip.
*Do you have an active Protection From Abuse Order or a court order that indicates any type of domestic violence?
*Are you over the age of 18?
I am interested in enrolling in PWSA's Customer Assistance Programs
Property Owner Contact Information
Property Owner Mailing Address
Property owners and/or property managers will receive copies of bills and notices related to the account, including high consumption notices and any termination notices.
Opt-Out Procedures
If you would like to opt out of the property owner and/or property manager receiving copies of the bills and other notices related to the account, please indicate below.


Property owners and/or property managers will continue to receive a past due notice 30-days after the date that the unpaid charges were issued.  If charges remain unpaid, PWSA will send a copy of the 10-day notice and all subsequent non-payment notices to the property owner and/or property manager. 

Signature
Sign above
* Unpaid water/wastewater/stormwater charges are a lien on the property, independent of whether the service is provided to a Tenant or other Non-Owner Occupant.  Any account with past due charges may be sent a reminder notice which shall contain notification that unpaid water/wastewater/stormwater charges are a lien against the property. Please read PWSA’s Supplemental Service Conditions for detailed information about liens.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.