There are two types of Residential Household claim forms:
Residential Household Simple Claim Form: You do not have to have any receipts or documentation. You only have to show that you lived in an eligible Household on January 9, 2014. Eligible Households that complete a Simple Claim Form may receive up to $550 plus $180 for each additional resident
Residential Household Individual Review Form: If your spill-related expenses are higher than the amounts available under the Simple Claim Form, you could receive even more money by filing an Individual Review Form along with receipts or other documents supporting those costs.
If you have receipts for actual expenses your household had for repair/replacement of water pipe system or appliances, extra expenses for water, food, lodging, or lost food caused by the Freedom Chemical Spill, you may want to file the Individual Review Form.
You will have to submit your receipts and documentation that shows the amounts and explains how the costs were caused by the Freedom Chemical Spill.
You do not have to have any receipts or documentation. You only have to show that you lived in an eligible Household on January 9, 2014. Eligible Households that complete a Simple Claim Form may receive up to $550 plus $180 for each additional resident.
Start Online Form
Download the simple claim form and mail it in. Once you print this form, you can complete it and mail it to:
WV Water Claims
PO BOX 4227
Charleston, WV 25364
Use this online form if your spill-related expenses are higher than the amounts available under the Simple Claim Form.
START ONLINE FORMDownload the individual review claim form and mail it in. Once you print this form, you can complete it and mail it with all supporting documentation to:
WV Water Claims
PO BOX 4227
Charleston, WV 25364
