Virginia SCC - Division of Energy Regulation

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Division of Energy Regulation

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Water-Sewer Complaint Form

Required fields are indicated with an asterisk (*).

First Name *	*
Last Name *	*
Phone Number *	*
Secondary Phone Number
Email Address
Street Address or PO Box *	*
City *	*
State *	*
Zip Code *	*
Utility Company *	*
Account Number
Complaint Type *	Please select a Complaint Type
Comments/Complaint *	*
Have you contacted the utility? * (If so, what was the utility's response.)	*

If you have electronic documentation that you would like to submit with your complaint, please attach one file using the browse button below.

The file type must be one of the following and cannot exceed 4,000 kilobytes (4 MB):

MS Word ( .doc )
MS Excel ( .xls )
Adobe ( .pdf )

Please click the browse button to attach a file from your computer.

If you have information that cannot be submitted electronically, please DO NOT submit this form. Please provide your complaint information and documentation by regular mail to: Division of Energy Regulation, P.O. Box 1197, Richmond, Virginia 23218.