Water Connection Application Form

Fill in the form below to apply for a new water connection. Ensure all required documents are attached.

PART A: Applicant / Customer Details

First Name

Last Name

Email Address

Phone Number

Gender

KRA Pin Number

Attach KRA Pin (Required) Max: 1MB • PDF, JPG, JPEG, PNG

National ID Number

Attach National ID (Required) Max: 1MB • PDF, JPG, JPEG, PNG

PART B: Details of Water Connection

Plot Number

House Number

Estate

Expected Number of Users

Name of Property Owner

Attach Title Document (Optional) Max: 2MB • PDF, JPG, JPEG, PNG

PART C: General Conditions

I hereby apply for a water and/or sewerage connection to the above premises. I understand that the connection will be effected after the Company's approval and payment of all fees and charges due and owing. I agree to pay for the services in accordance to the prevailing tariffs and subsequent revisions as gazetted in law. The Company shall not accept personal cheques as mode of payment. I undertake to abide to the by-laws and regulations relating to water supply and sewerage services.

Signature

Date

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Water Connection Application Form

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PART A: Applicant / Customer Details

PART B: Details of Water Connection

PART C: General Conditions