Government

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

Two ways to submit your form

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Government Form Online

SUBMIT YOUR FORM ONLINE

Our online form will be coming soon. Until then, please download a Government Claim Form on the right.

Return to Claims
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OR DOWNLOAD FORM

PRINT AND MAIL IN YOUR SIMPLE 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