Pay My Bill
Customer Portal
E-News
PCWA Logo
Home
About
Customer Services
Business With PCWA
Newsroom
Water Shutoff Protection Self Certification Form
Customer Account Information
First Name
*
First Name *
Last Name
*
Last Name *
Account Number
*
Account Number *
Owner or Tenant
*
Owner
Tenant
Service Address
*
Service Address *
Billing Address
*
Billing Address *
Phone Number
*
Phone Number *
Email
*
Email *
Qualification Information
PCWA Treated Customer
*
PCWA Treated Customer *
Household Assistance
*
Household Assistance *
Household Income Requirement
Household Income Requirement
Primary Care Certification
*
Primary Care Certification *
Payment Plan Agreement
Payment Plan Agreement
Policy on Discontinuation of Residential Water Service for Nonpayment
Review Policy
Scroll down to continue
Water Shutoff Protection Act Form
Declare Understanding & Agreement for
You must sign this form by typing your name
Name
*
Submit Application
PCWA Logo
144 Ferguson Road
P.O. Box 6570
Auburn, CA 95604
Mon. - Thurs., 8am - 5pm
(530) 823-4850
Mon. - Fri., 8am - 5pm
Report Water Waste
Contact Us
Subscribe to E-News
Also on
Copyright © 2026
Placer County Water Agency
All Rights Reserved |
Privacy Policy
Weather Provided by
OpenWeather
