Use the form below to apply to become an occupant water customer.

Please complete the form and submit it to the Water Revenue Bureau (WRB). This is a fillable form, meaning you can complete all the fields –including the signature– on your computer. However, you may need to update Adobe Reader.

Once complete, please submit the form and required documents by email. Save the completed form as a PDF file on your computer, or take a clear picture with your smartphone, and email it to wrb.contactintake@phila.gov.

Please include your name and address in the subject line.  A WRB customer representative will reply with the status of your application and further instructions.

You can also send your form and copies of documents by mail to:

City of Philadelphia
WRB Intake / CU – 3rd Floor
1401 John F. Kennedy Blvd.
Philadelphia, PA 19102

Or use the Intake Unit drop-off box, located at the lobby level of the Municipal Services Building:
1401 John F. Kennedy Blvd.

You can also bring in your application to our Northeast Philadelphia satellite office: 7522 Castor Ave., Philadelphia, PA 19152.

If you have questions about how to complete or submit this form, call (215) 685-6300.