Form Center

2. 
3. Coachella Valley Water District
   Irrigation Water Availability Assessment / IWAA
   Request for Remaining Balance
   
   Please complete the form below. To request information for more than 10 meters, submit multiple forms.
   
   
5. Please provide your information below
7. First Name*
8. Last Name*
10. Email Address*
12. Primary Telephone Number*
13. Primary Telephone Number Type*

    1. Cell Phone
    2. Home
    3. Work
17. 1. Parcel Number*
18. 12-digit CVWD Account Number*
20. Property Owner*
22. Remaining balance
26. 2. Parcel Number
27. 12-digit CVWD Account Number
29. Property Owner
31. Remaining balance
35. 3. Parcel Number
36. 12-digit CVWD Account Number
38. Property Owner
40. Remaining balance
44. 4. Parcel Number
45. 12-digit CVWD Account Number
47. Property Owner
49. Remaining balance
53. 5. Parcel Number
54. 12-digit CVWD Account Number
56. Property Owner
58. Remaining balance
62. 6. Parcel Number
63. 12-digit CVWD Account Number
65. Property Owner
67. Remaining balance
71. 7. Parcel Number
72. 12-digit CVWD Account Number
74. Property Owner
76. Remaining balance
80. 8. Parcel Number
81. 12-digit CVWD Account Number
83. Property Owner
85. Remaining balance
89. 9. Parcel Number
90. 12-digit CVWD Account Number
92. Property Owner
94. Remaining balance
98. 10. Parcel Number
99. 12-digit CVWD Account Number
101. Property Owner
103. Remaining balance
107. By typing or signing my name, I certify that I am authorized to request and receive the information submitted on this form.*
109. COACHELLA VALLEY WATER DISTRICT
     Post Office Box 1058
     Coachella, California 92236
     (760) 391-9600
     (760) 398-3190 - fax
     CustomerBilling@cvwd.org
     
     rev 01/2021
Leave This Blank:


110. 1. Receive an email copy of this form.
111. Email address

     This field is not part of the form submission.

112. Submit

* indicates a required field