Please fill out the form below and click "Display Form" at the bottom of this page to generate a
PDF document that you can print, sign and deliver to our office.
Date Requested to Start New Service:
Federal Tax ID#:
Social Security No:
Drivers License No:
Landlord Name if you Rent:
I acknowledge, the Inman-Campobello Water District has provided me with a water rate
of fees. I have been advised I will receive a monthly bill with a due date of 20 days from
date of the bill. Should I not receive a bill, I will be responsible to contact the ICWD
Office to verify the bill amount and the due date and will not hold the ICWD responsible for
bills that I did not receive due to U.S. Postal deliveries.
I agree to pay all charges incurred until I have given notice to discontinue my service with
the Inman-Campobello Water District. I understand if the balance on my account reflects a
due amount and my account has been charged a non-payment fee, my service will be subject to
disconnection. The past due amount and the non-payment fee must be paid to have service
restored or continued. I agree to pay all fees and costs incurred if collection procedures
become necessary to satisfy past due balances for service.
By signing this application for water service, the applicant
agrees to pay all cost of collection of the applicant's unpaid bills. The
Inman-Campobello Water District has the
right pursuant to the South Carolina Setoff Debt Collection Act to collect any sum due and
owed by the applicant through offset of the applicant's state income tax refund. If the
Inman-Campobello Water District chooses to
pursue debts owed by the applicant through the Setoff Debt Collection Act, the applicant
agrees to pay all fees and costs incurred through the setoff process, including fees charged
by the Department of Revenue, the South Carolina Association of Counties, the Municipal
Association of South Carolina, and/or the
Inman-Campobello Water District.
If the Inman-Campobello Water District
chooses to pursue debts in a manner other than setoff, the applicant agrees to
pay the costs and fees associated with the selected manner as well.
Required Documents for New Service:
$30.00 Non-Refundable New Service Fee and Drivers License
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