Jefferson Regional Water Authority Online Forms & Reports
New Customers 
Existing Customers           
Online Reports

The Forms on this page may be downloaded and viewed with Adobe Acrobat Reader. 



Please check back for  downloadable documents as they become available.


Customers may fill out the form by selecting fields with the mouse, or using tab to navigated between fields. If a field is too small for the font you are using, you can change fonts or fill out the field neatly by hand after printing. You can then send the form in by e-mail, mail, and fax or by bringing the completed form to our local office. 


Copyright © JEFFERSON REGIONAL WATER AUTHORITY. All rights reserved. 

email copy.png
  • Facebook Social Icon
  • Twitter Social Icon
  • YouTube Social  Icon

CALL US: 937-866-0002

24HR EMERGENCY: 937-225-4357

Message from JRWA Utility:
    If you plan on Digging on your property Please call

OUPS before you dig- Dial 811