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Bloomington CiviForm
Note: Fields marked with a * are required.
If you're able to, please provide your City of Bloomington Utilities (CBU) account number. *
You must be an active CBU customer to receive assistance. This is a 2-9 digit number followed by a dash (-) and then 3 more digits. It can be found in the table at the top of your water bill (3rd row).