COVID-19 Relief Program

We understand these are difficult times. If you have missed payments due to a loss of income, health issues, or other economic setbacks related to the pandemic, we are here to help. Fill out the form below to enroll in the COVID-19 Relief Program.

First Name

Last Name

Customer Number

Your customer number can be found on your water bill, in the top right corner.

Address

Water Service Address

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number

E-Signature Verification

By checking this box, I certify that I have been financially impacted by COVID-19 and that my income falls within Marin Water's income guidelines. I also certify under penalty of federal law that the information provided is true and accurate.