Forms • Galveston, TX • CivicEngage

Customer Service Resolution Form

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Date*
Customer Name*
Customer Phone Number*
Customer Account Number*
Customer Location Number*
Billing Date
Total Amount
Usage Amount
Month in Question*
Date of Last Service Request
Last Meter Reading
Customer Explanation*
Customer Signature and Date
Customer Service Rep
Customer Service Superintendent
Assistant Finance Director
Recommendation
Customers will receive a decision from customer service within 30 days regarding their request. If you would like us to email you, please provide a valid email address

* indicates required fields.