3622 Sagunto Street Santa Ynez, Ca 93460


Forms and Applications

Forms and Apps

Our Office encourages its customers to download their forms via the internet whenever possible.  In the case the form requires a Notary Public, the form may be filled out in advance, but you must wait to sign and date them until you are actually in the presence of the Notary official.  The forms listed below are available in electronic format. Just click the item you want.  The form will open automatically if Adobe Reader is installed on your computer.

Direct Debit Authorization Form - Water District customers have the option of having their water bill payments automatically deducted from their checking account by completing the Direct Pay Authorization Form.  This form is not submitted online - Completed forms, accompanied by a "VOIDED" check from the checking account that will be debited, must be mailed to PO Box 157 Santa Ynez, CA 93460 or hand delivered to 3622 Sagunto Street, Santa Ynez.

Discontinue Direct Debit Program Form -  Water District customers wishing to discontinue Direct Debit Program.  Please download the form and submit the completed form to District Administrative office. 

Service and Billing Agreement Card - Customers wishing to open an account for water service must complete a Service and Billing Agreement Card and submit a $75.00 application fee prior to activating an account.  The Service and Billing Agreement form will ask for the customer's name, service address, mailing address, date service is to begin, telephone number and employer information.  

Application for Tenant Billing - Accounts may be billed to tenants as a convenience to the owner upon filing of the Application for Tenant Billing form.  Although, all charges for water will be the ultimate responsibility of the property owner.

Special Services Request Form - Use this form to request any type of Public Information from the Water District.

Credit Card Payment Authorization Form - Use this authorization form when making a credit card payment.

Public Records Act Request Form - This form lets you request public information pursuant to the California Public Records Act (Section 6250 and following of the Government Code).

Request for Temporary Service Connection - Use this form to request a temporary hydrant meter.

Service Discontinuance Request - Use this form to discontinue service.

Agriculture Customer Activation/Seasonal Discontinuance Agriculture Customers must use this form to request water service activation or discontinuance.

Water Service Application - The District is currently in an Emergency Water Supply Shortage declared by the Board of Trustees on June 17, 2014.  As a result, the Board of Trustees has suspended issuance of any "Can Will Serve" letters and new or expanded water service at this time.  Should an applicant choose to submit a Water Service Application for new or expanded water service, the applicant is hereby notified that the District's review and processing of an application does not constitute, nor commit or imply that the District will provide or approve water service.

Current List of Backflow Testers - List of approved backflow testers.

Schedule of Administrative Charges