Water Meter Check

To [Water utility]
                                                  [Utility address]

                                                  from [Full name]
                                                  Address:
                                                  [Applicant address]
                                                  Phone: [Phone]

                                      REQUEST
                     for verification (inspection) of a water meter

Please arrange verification of the cold/hot water meter installed at the address: [address].

Meter details:
- Serial number: [meter number]
- Installation location: [kitchen/bathroom/other]
- Date of last verification: [date]

Preferred verification date: [date].



I guarantee payment for the verification service.

Attachments:
1. Copy of an identity document.
2. Copy of the previous verification report (if available).

12/04/2026                                                         _______________
                                                                       (signature)