Warrenton Utility Bill Payment Agreement
This file contains the utility bill payment agreement for the Town of Warrenton. It outlines the terms and conditions of the payment plan, including responsibilities and timelines. Use this document to formally request a payment plan for your water and sewer bills.
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How do I fill this out?
Filling out this form requires careful attention to detail. Begin by providing your account information, including your name and contact details. Follow the instructions provided for the payment plan agreement to ensure your request is processed correctly.

How to fill out the Warrenton Utility Bill Payment Agreement?
1
Enter the name and contact information.
2
Provide the service and billing addresses.
3
Input your account number and current balance due.
4
Specify the agreed payment dates and the amount.
5
Sign and date the agreement.
Who needs the Warrenton Utility Bill Payment Agreement?
1
Current utility customers needing payment flexibility.
2
Residents facing financial hardships requiring payment arrangements.
3
Landlords managing multiple accounts needing payment plans.
4
New customers setting up service needing payment terms.
5
Individuals seeking to avoid utility service disconnection.
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Review your edits for accuracy.
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What are the instructions for submitting this form?
To submit this form, please complete it in full and print it out. You can then bring it to the Town of Warrenton office located at 21 Main St., Warrenton, VA, or send it via email to utility@warrentonva.gov. For any urgent queries, you may contact the finance department directly via phone.
What are the important dates for this form in 2024 and 2025?
For the years 2024 and 2025, payments must be made by the 20th of each month to avoid service disconnection. Important due dates for payment agreements will be set at the time of application approval. It is crucial to adhere to these dates to maintain utility services without interruption.

What is the purpose of this form?
The purpose of this form is to provide a structured agreement for utility customers in Warrenton who are experiencing financial difficulties. It allows customers to formally express their intention to settle their utility bills over a specified period. Moreover, it aims to prevent service disruptions through manageable payment schedules, ensuring continued access to essential water and sewer services.

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

- 1. Name: The name of the customer requesting the agreement.
- 2. Phone#: The customer's contact number.
- 3. eMail: The customer's email address.
- 4. Service Address: The location where service is provided.
- 5. Billing Address: The address used for billing purposes.
- 6. Account #: The unique account number assigned to the customer.
- 7. Total Amount Currently Due: The total amount owed at the time of request.
- 8. Date Requested: The date the request for payment plan is made.
- 9. Date Account will be paid in full: The date by which the account balance is to be cleared.
- 10. Payment agreement dates: The specific dates agreed upon for payment.
- 11. Customer Signature: Signature of the customer to accept the terms.
- 12. Date: The date of the customer's signature.
- 13. Town of Warrenton Representative: Signature of the representative confirming the agreement.
- 14. Date: The date of the representative's signature.
What happens if I fail to submit this form?
Failing to submit this form can result in your account remaining delinquent, leading to potential disconnection of utility services. Additionally, customers must understand the implications of not adhering to the payment plan they establish.
- Service Disconnection: If the form is not submitted or payments are not met, service may be disconnected.
- Late Fees: Failure to adhere to the plan may result in incurring late fees.
- Reconnection Fees: Customers may have to pay reconnection fees to restore service.
How do I know when to use this form?

- 1. Financial Hardships: When facing unforeseen circumstances impacting your ability to pay your bills.
- 2. Setting Up New Service: If you are a new customer and wish to establish a payment regime.
- 3. Avoiding Service Disruption: To ensure service remains uninterrupted while payments are processed.
Frequently Asked Questions
How do I fill out the payment agreement?
Begin by entering your account details and payment terms as instructed on the form.
What if I miss a payment date?
Missing a payment will nullify the agreement, and disconnection of service may occur.
Can I change my payment plan terms?
Any changes must be discussed with the Town of Warrenton finance department prior to the due date.
Is there a fee for payment plan setup?
There are no fees associated with setting up your payment plan as long as payments are made on time.
How can I access my utility account?
You can access your account details by contacting the Town of Warrenton utility office.
What happens if my payment is late?
Late payments will incur penalties and could lead to service termination.
Can I request a payment extension?
Extensions may be negotiated under special circumstances with the finance department.
Where can I send my completed agreement?
Submit your signed form to the Town of Warrenton as directed on the form.
Will I receive notifications before disconnection?
No additional notices will be sent before service disconnection.
What if I need assistance with the form?
Assistance is available by contacting the Town utility office during business hours.