HomeMy WebLinkAboutFee Waiver Adjustment Request_2026_________________________________________________________________________________________________________________
City of Renton Utility Billing • 1055 S Grady Way, Renton, WA 98057 • 425-430-6852 • ub@rentonwa.gov • rentonwa.gov
City of Renton Utility Billing Fee Waiver/Adjustment Request
Account #: Date:
Service address:
Fee Amount:
Date Fee
Charged:
Fee Description:
I am requesting a waiver of the fee described above for the following reason(s):
Attach documentation if applicable
ELIGIBILITY FOR FEE WAIVERS
Fees are not waived lightly or on a regular basis since they represent an expense to the city.
All requests for fee waiver or adjustment must include this completed form and supporting
documentation (if applicable) to demonstrate eligibility for the requested fee waiver or adjustment.
Disconnection of service fees (shut off fees) will not be waived unless an error was made by staff or
the ratepayer can demonstrate a serious financial hardship.
Returned item fees will not be waived unless a ratepayer can demonstrate fraudulent activity on the
bank card/account used that required closure of the affected account.
Approval of fee waiver or adjustment requests is not guaranteed.
Signature: ☐Owner ☐Tenant
Name: Email:
Office Use Only: ☐Approved ☐Denied
Authorized Signature: Date: