UGU District Municipality
Residents Request for Service / Report
UGU DM is responsible for all Water, Sanitation and Public Health.
If you wish to report any other need then please use the RNM form on your Cllrs App
Reporting Date
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Hour
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Minutes
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PM
AM/PM Option
Local Municipality
*
Ray Nkonyeni
Umdoni
Umzumbe
Umuziwabantu
Municipal Ward Number
*
Municipal Ward Number choice
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Service request
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Water Service interruption
Water quality report
Line burst report
Vacuum Tanker Services
Sewerage overflow or leak report
Environmental Pollution
Account query
Suspected faulty meter
General Question/Input
Other
Details of Service Required or Report
Location of service/report required if different to address submitted below
Optional. Please attach any documents or pictures that you feel are relevant to your request. Please have your camera on low resolution
Select File
Cancel
of
Full name
*
Address where service is required or related to input
*
Street number and name or nearest landmark
Suburb/Area
Ward
State / Province
Postal / Zip Code
Cell number
*
Land Line
email address
ID Number/Birthday details (optional) but requested
You can also submit your monthly Meter Reading
Remember to enter your name and address above as well
Account Number
If you are submitting your meter reaqding
Submit your Meter Reading
You must submit your account number
Do you wish your Councillor to assist?
Yes
No
Preferred method of contact for Reference Number
Cellular/SMS
email
Submit
Print Form
Should be Empty: