Leakage allowance claim form

Please note that two meter readings, taken two weeks apart are required in order for you to complete this form. The first after the repair is done and the second two weeks later. If you're unable to take the readings please contact us so we can arrange this for you.

Your name: *

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Account number:*

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Address where the leak occurred: *

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How many people live in your property? *

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About the leak

On what date did you become aware of the leak? *

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How did the leak occur? *

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Were Hafren Dyfrdwy involved in detecting the leak? *

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Reference Number

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Who carried out the repair? *

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If other, please specify:

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About your meter

What date was the repair carried out and what was the meter reading on this date? *

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Please provide serial number on your meter: *

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Please give us a reading taken at least two weeks after the repair date and also confirm the date you took the reading: *

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If you've taken any other readings recently, please let us know those and the relevant dates:

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If you're unable to provide meter readings, please provide a reason:

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Did the leak occur on the meter: *

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If no, how far from the meter did it happen?

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Please let us know any other information you think might be relevant to your claim:

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Please provide a detailed description with the following information:

a) the position of your meter b) the position of the leak in relation to your property and the meter c) the approximate distance between the meter and your property d) where the lost water drained to, eg the ground, a public highway, sewer etc

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Final details

It would be helpful if you could provide your email address and a telephone number we can use if we need to discuss your claim. If you’re happy to give us this information but don’t want us to add it to your file for future use please click here

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Email address:*

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Daytime phone number:*

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Please tick the box if: *

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