Fort Bend Subsidence District
Serving the Gulf Coast Community Since 1975

Application for Groundwater Credit Rebate
Submit one application form and fee within seven (7) days to the above address for each aggregate well system. The application fee is $25.00 for one (1) well, or if you have more than 1 well, a total of $50.00 is due for the entire aggregate system. The form and fee must also be received within ninety (90) days after the termination date of the permit(s) to be considered for a rebate.

Groundwater certificates will be rebated as a percentage of the total amount of water used.

Items marked with an * are required.

*Well No:
*Well Owner:
*Owner Email:
*Mailing Address:
*Name of Representative:
*Phone Number:
 (###-###-####)       Ext.:  
Permit Term
Current Term - Begin:
*Previous Allocation:
 (MG), as shown on permit(s).  
*Actual Withdrawal:
 (MG), during the permit term, not calendar year.   
Unused Allocation:**
0.000 (MG)
  **(Previous Allocation - Actual Withdraw)
*Actual Alternative Water Use:
 (MG), during the permit term, not calendar year.  
*Staff may request additional supporting documentation or details.
I request that a rebate of that portion of the Groundwater CreditRebate, represented by the unused allocation, be granted pursuant to Rule 5.6 of the Rules of the Fort Bend Subsidence District.
*Was a water meter installed and operating for the full permit term.(Explain)
*Applicant/Agent Name:
*Email Address:
*Confirm Email Address:
Richmond, TX 77469-0427  •  P.O. Box 427
Phone: (281) 342-3273  •  Fax: (281) 232-3355