Government

Governmental entities that lost tax revenue and faced extraordinary expenses and that were being served tap water by West Virginia American’s Kanawha Valley Water Treatment Plant on January 9, 2014 are eligible to make a Governmental claim.

You should complete this form if your governmental entity operated in a location that was provided tap water service from West Virginia American’s Kanawha Valley Water Treatment Plant on January 9, 2014, you believe you have documented losses higher than the simple claim payment amount, AND you are requesting an individual review for your Governmental Claim as explained in the claim form instructions.

Two ways to submit your form

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Government Form Online

SUBMIT YOUR FORM ONLINE

Click here if you are requesting an individual review for your Governmental Claim as explained in the claim form instructions.

START ONLINE FORM
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OR DOWNLOAD FORM

PRINT AND MAIL IN YOUR CLAIM FORM

Download the Government Claim Form and mail it in. Once you print this form, you can complete it and mail it with all supporting documentation to:

WV Water Claims
PO BOX 4227
Charleston, WV 25364

Download form