Form Center

2. Appeal Form

   The Appeal Process is a procedural review by a designated committee that ensures the Ashland Municipal Code Chapter 14.02 was followed. The City does not have the ability to arbitrarily reduce or waive charges unless an error was made. 

4. Utility usage such as a water audit or electric audit is available to you to help reduce your monthly utility bill. Visit the Water Conservation Program page or the Energy Conservation page for more information.

6. The City also provides Assistance Programs for qualified applicants as outlined on the Utility Billing Customer Service webpage. Should you need additional financial help, please visit this webpage for the contact information of agencies that may be able to assist.

10. Link to Utility Billing Customer Service Webpage
    Utility Billing Customer Service Webpage
12. First Name*
13. Last Name*
15. Service Location Address*
17. Email Address*
18. Phone Number*
20. Utility Account Number
21. Customer Number
23. Do you believe that the City did not follow the Ashland Municipal Code section 14.02? If so, please explain.
25. Are your services disconnected?
27. Have you received a delinquent notice?
29. Have you submitted a request for a payment plan?
31. If yes, have you returned the signed payment plan agreeing to the amount and term by the date due?
33. If you answered no to the previous questions, please fill out the request using this link
    Payment Plan Form
35. Have you reached out or received funds or pledges from assistance agencies?
37. If you answered yes to the previous question, please provide dates of appointments.
39. Have you applied for either an Ashland Low Income Energy Assistance Program or Senior and Disabled discount through the City of Ashland, if applicable?
41. Circumstances leading to disconnection. What would you like the Appeal Committee to consider:

47. The appeal will be reviewed by the Appeals Committee and they will present their finding to the Finance Director. The Finance Director will notify the customer of the determination.

     

    • If the appeal is successful, it may include an additional payment plan, and a payment plan agreement provided to the customer.
    • If the appeal is unsuccessful, the Customer’s service will be disconnected if payment in full is not received within 14 days. In accordance with the Ashland Municipal Code, section 14.02.110, a deposit and reconnection fee must be paid as well as the past due balance to retain service.

    I certify that the above information is true to the best of my knowledge.

49. Signature of Applicant (Type Name)*
50. Date*
Leave This Blank:


52. 1. Receive an email copy of this form.
53. Email address

    This field is not part of the form submission.

54. Submit

* indicates a required field