Making it easier for you to get the right support

No one should worry about their water bill, that's why we've got a range of help available for those that need it.

Knowing what support you're eligible for, and spending time filling out different forms, can be stressful. We've created our single application form to make it easier for you! You just need to fill out the form below and our people will take it from there, matching the right support for your individual needs.

Before filling out the application form, you can check to see if you're eligible for benefits here.

Application for support

If you do not have a water meter, by submitting this application form you authorise us to arrange for one to be installed if possible. If you are unable to fill out this form online, click here for a PDF version.

Full name

Customer number (You can find this on your water bill)

Contact telephone number

Email address

Postcode

Pick an address

Address

Town or city

County

Postcode

Country

Current meter reading

What is your other income from Benefits or Tax Credits?

Housing Benefit

Amount in £

Jobseekers Allowance

Amount in £

Jobseekers Allowance (income based)

Amount in £

Income Support

Amount in £

Working Tax Credit

Amount in £

Child Tax Credit

Amount in £

Child Tax Credit (family element)

Amount in £

Child Benefit

Amount in £

Employment and Support Allowance

Amount in £

Employment and Support Allowance (income-based)

Amount in £

Statutory Sick Pay

Amount in £

Carer’s Allowance

Amount in £

Universal Credit (Housing element)

Amount in £

Universal Credit (Standard Allowance element)

Amount in £

State pension(s)

Amount in £

Private or work pension(s)

Amount in £

Pension Credit

Amount in £

Pension Credit (Guaranteed element)

Amount in £

Other Benefit or Tax Credit (Please Specify)

How would you like to pay your bill?

Direct debit Standing order Flexible payment plan WaterDirect

If you are struggling to pay your water bill or have debt with us, please provide more information regarding your circumstances as we may be able to help you.

DECLARATION

The information I have given is correct to the best of my knowledge and I understand that if I provide any information which is false, you may refuse to consider my claim. If my circumstances change and it may affect my claim, I will tell you straight away.

I give the authority who gives me benefit or tax credit the permission to give you any information to confirm the information I have provided. If I have made a claim because of a medical condition, I give the medical professional who knows about that condition permission to give you my information about the condition and why I need to use more water, to confirm the information I have provided. If I pay my sewerage charges to a different company, my letter gives you permission to pass on the details I have provided so that you can also consider my sewerage charges under the WaterSure scheme.

The information you provide is kept on a secure register restricted to only those employees of South West Water and our partners who need to know it. It is not disclosed to anyone else under any circumstances

By signing this form, you agree for a water meter to be installed if possible, as this can help you manage your water usage.

Warning: If you deliberately give us misleading information you are committing a criminal offence and could be prosecuted.

Your name

Date

Name of person receiving benefit(s) (if they are not the person named on the water bill). We need this name for Data Protection purposes.

Name

Date

By providing evidence, we will be able to process your application quicker.

The information we're looking for is:

‣ A photocopy of the latest 'notice of entitlement' for the benefits or tax credits

‣ The last bank statements for you and all other adult family members in your household

‣ If you're applying because of a medical condition then please attach a copy of your repeat prescription form or a doctor's certificate explaining your condition and why you need to use extra water, and date prescription or certificate was issued

‣ If you're applying because you have a large family then please attach a copy of the latest 'notice of entitlement' to Chlld Benefit for each child you list here.

Upload your evidence here

Would you prefer to speak to us about the support we offer?

We've made it easier for you to contact us. Don't wait, send us a message on whatsapp, facebook, or twitter, and we'll get back to you. Or, you can chat to us on webchat by clicking on the message us button to the right.

If you'd prefer to speak on the phone, please call us on 01202 590059. We’re open 8am – 6pm Monday to Friday and 9am – 2pm on Saturday.