Application for the Job Centre Plus to arrange Water Direct

If you receive Income Support, Jobseeker's Allowance, Employment Support Allowance (ESA), Pension Credit or Universal Credit, the Job Centre Plus might be able to arrange for your water bill to be paid out of your benefits.

Please complete the online application form below. Alternatively, simply call 0345 6022 777 and we will make the application on your behalf.

The asterisk (*) symbol denotes required fields.

First name - Person receiving benefit *

Please enter a valid first name - person receiving benefit

Surname - Person receiving benefit *

Please enter a valid surname - person receiving benefit

House/Flat Name/Number *

Please enter a valid house/flat name/number

Road / street name *

Please enter a valid road / street name

Town

Please enter a valid town

City

Please enter a valid city

County

Please enter a valid county

Postcode *

Please enter a valid postcode

Email address *

Please enter a valid email address

STW Account number

Please enter a valid stw account number

National Insurance Number *

Please enter a valid national insurance number

Bill payer name if different from above

Please enter a valid bill payer name if different from above

Date of Birth *

Please enter a valid date of birth

Home Telephone Number (including STD)

Please enter a valid home telephone number (including std)

Mobile number (if applicable)

Please enter a valid mobile number (if applicable)

Benefits received (please select) *

Please select a title

Please tick the box if: *

Please select a title

Please tick the box if:

Please select a title