On submitting this form, one of our customer service agents will contact you to discuss your application and help to tailor any repayment arrangements to your circumstances.

Click here for further information or view the terms & conditions of our repayment scheme here.

You must complete this form as fully and as accurately as possible, otherwise we may not be able to process your claim.

Business details
Your details
Meter details
Is the supply metered or unmetered Is the supply metered or unmetered?*

To view our top tips for taking a meter reading, click here.

Please give the addresses of any of your premises that are, at the date of this form, closed to workers, the public or visitors due to Covid-19, and if applicable, the date you notified us of this.
If you have multiple premises closed, please list the addresses below and the date you notified us that they were closed.
Please give the addresses of any of your premises that have NOT closed, or have now re-opened and, if applicable, the date you notified us of this
If you have multiple premises opened, please list the addresses below and, if applicable, the date you notified us that they were re-opened.
If any of your premises do remain open, have your overall business or operational activities been reduced by at least 95%? If so, please provide details including evidence e.g. website screenshots, photos, reduced orders or revenue.
If none of the above apply, are you nonetheless experiencing payment difficulty as a result of Covid-19?*
If none of the above apply, are you nonetheless experiencing payment difficulty as a result of Covid-19?
If yes, we are required to seek reasonable evidence of this, which could include partial closure, major change to business (e.g. to online / collect only), reduced consumption, photographic or  documentary evidence (reduced orders, revenue, staff laid off or on furlough, or reduced activity (e.g. output / staffing records, accounts), and a meter reading (as shown above).
Did your business receive any funding through any of the Covid-19 government schemes? If yes, please detail below.
Please provide your best estimate of when you might expect to resume normal payment patterns e.g. on lifting of restrictions.
Additional information
Confirmation
I confirm that the information provided on this form is correct. *
I understand that Castle Water reserve the right to reverse any changes submitted by me if they are incorrect or challenged by another party* *