Water District 19 Shut-Off and Reconnection Notice
This document contains important information regarding your water service account. It outlines the consequences of non-payment and provides instructions for reconnection. Always keep this document handy for future reference regarding your water service.
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How do I fill this out?
To fill out this document, start by providing your account details at the top. Next, ensure to include any late fees or outstanding amounts. Finally, follow the outlined instructions for payment to avoid service disruption.

How to fill out the Water District 19 Shut-Off and Reconnection Notice?
1
Locate your account details at the top of the document.
2
Fill in the total balance due and any late fees.
3
Provide your personal information as indicated.
4
Review your entries to ensure accuracy.
5
Submit the completed form as instructed.
Who needs the Water District 19 Shut-Off and Reconnection Notice?
1
Customers with a past-due water bill to understand their obligations.
2
Landlords needing to reinstate water service for tenants.
3
Residents planning to set up a payment plan with the district.
4
New homeowners who receive this notice after a property transfer.
5
Consumers looking to resolve service issues with the water district.
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Select the text you wish to edit and change it as needed.
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Review all changes to confirm accuracy.
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What are the instructions for submitting this form?
To submit this form, you may email it to the water district at water19@water19.com. Alternatively, you can fax it to 206-463-1262. For physical submissions, send it to Water District 19, 17630 100th Avenue S.W., Post Office Box T, Vashon Island, Washington 98070 for prompt processing.
What are the important dates for this form in 2024 and 2025?
Important dates for managing shut-off and reconnection notices will typically include the last payment date to avoid disconnection and the date for reconnection service after payment. It's essential to keep track of these dates for seamless service. Always check with Water District 19 for specific timelines relevant to your account.

What is the purpose of this form?
The purpose of this form is to inform residents about the status of their water service account, especially in cases of non-payment. It serves as a reminder of the financial obligations to maintain water services, along with penalties for delays. This document outlines the steps needed for reconnection and the importance of timely payments.

Tell me about this form and its components and fields line-by-line.

- 1. Account Number: Your unique account identifier with the water district.
- 2. Amount Due: Total outstanding balance including fees.
- 3. Customer Name: Your full name as registered with the water district.
- 4. Address: Your service address for the water account.
What happens if I fail to submit this form?
Failure to submit this form may result in the disconnection of your water service. To avoid this situation, ensure that all required information is completed and submitted in a timely manner.
- Service Interruption: Non-payment may lead to disruption in water services.
- Reconnection Fees: A fee will incur for reconnecting water service after disconnection.
- Legal Actions: Continued non-payment may result in further collection actions.
How do I know when to use this form?

- 1. After Receiving Shut-Off Notice: Use this form to respond promptly and pay necessary fees.
- 2. To Establish Payment Plans: Residents can fill out this form to negotiate payment structures.
- 3. For Service Restoration: After disconnection, this form facilitates the process for reconnecting service.
Frequently Asked Questions
How do I know if my account is at risk for shut-off?
Check your latest billing statement for any overdue amounts.
Can I set up a payment plan through this form?
Yes, please follow the instructions provided to initiate a payment plan.
What should I do if I see incorrect information on the notice?
Edit the PDF directly to correct any errors before submission.
How quickly will my service be restored after I pay?
Generally, service can be restored within one business day after payment confirmation.
Are late fees mentioned in the document negotiable?
Late fees are typically fixed, but you can inquire with customer service for assistance.
Do I need to pay the reconnection fee immediately?
Yes, the reconnection fee is required to reinstate service.
Is there a way to prevent my water service from being shut off?
Timely payments and communication with the water district can help prevent service interruptions.
What other payment methods are accepted?
Check the document for accepted payment methods or contact customer service.
Can I edit this document on mobile?
Yes, PrintFriendly is mobile-friendly and you can edit the document on your phone.
How do I download my edited document?
After editing, simply click the download button to save your changes.
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