Payment arrangement form

We recognise the significant financial stress on many households and businesses and we're here to help.

Approved payment arrangement requests will receive either an email or text confirmation within 3 business days.

Note: If you have more than one account, you will need to submit individual forms for each account.

You can also get in touch with us to discuss your circumstances via Webchat, Facebook or Twitter; or by phoning our General Enquiries line on 13 26 57 (8am – 5pm weekdays).

Do you require a payment arrangement for a residential or business property?

All fields are required unless stated otherwise.

Customer Reference Number ?

Enter your 15 digit customer reference number (with no spaces) as shown in the top right corner of your bill.

Account holder's name ?

Please provide the name(s) of the registered property owner(s) or authorised representative(s) as shown on your Water and Sewerage bill.

Street address

Enter the property location as shown on your bill.

Suburb

Enter the suburb where your property is located.

Postcode

Your name

Enter your first and last name.

How you would like us to send you confirmation of your new payment date?

As this arrangement is only for the current balance, are you able to pay future bills in full? (optional)

Payment installments

When would you like your payments to occur?

How much would you like to pay? ?

Commencement date ?

IMPORTANT

By submitting this application, you declare that you are the named Account Holder of the Urban Utilities Water and Sewerage Account for the property stated above, and you understand that you may be required to provide further information in order for your request to be processed.

If the arrangement requested in this application is approved, interest will not accrue on your account while you are honouring the arrangement.

Please remember it's important that you contact us if you can’t meet these agreed installment payments, so that we can assist with an arrangement that suits your needs.

Privacy and why we collect your information

Your privacy is important to us. Urban Utilities is collecting your personal information as a distributor-retailer under the South-East Queensland Water (Distribution and Retail Restructuring) Act 2009 (Qld) for the purpose of processing and responding to your enquiry and updating our customer and billing records.

The personal information we collect may also be used to manage and make contact with you about accounts and to verify your identity in future; to contact you about network faults and emergencies and manage the water and sewerage services we provide; and to conduct customer research.

Urban Utilities may use and/or disclose your personal information to its employees, agents or contractors for these purposes and to other third parties as otherwise required or authorised by law

For more on how we protect the personal information we collect, and to find out how to make a privacy complaint, access our Privacy Policy.

Please press the submit button once, and wait for the form to process.