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  1. Water District
  2. Coachella Valley Water District
    Request to Enter Into a Payment Plan

  3. Please read and complete the information below to request a payment plan.

    I understand and acknowledge that:*
    (Check all that apply)
  4. Primary Telephone Number Type*
  5. Secondary Telephone Number Type
  6. Timeframe requested to pay balance:*
  7. Acknowledgement*
  8. Terms & Conditions
    If approved, I hereby agree to pay the installment payments IN ADDITION TO my monthly charges. I understand that my first payment will be due starting with my next monthly bill.

    I agree to keep my account current during the time period requested above. If I fail to make payments as agreed upon, the payment plan will become void, delinquency fees and late charges will be added to my account, and the total outstanding balance will become due IMMEDIATELY.
    Post Office Box 1058
    Coachella, California 92236
    (760) 391-9600
    (760) 398-3190 - fax

    rev 11/2020
  10. Leave This Blank:

  11. This field is not part of the form submission.