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This report discusses the key findings and recommendations emerging from a pilot Citizen Report Card (CRC) on water, sanitation, and sewerage services in Karachi. This initiative comes, on one hand, in the wake of deteriorating services, weakened community interfaces and accountability structures, poor revenue generation and dysfunctional governance structures and, on the other, an emergent consensus to bring in far-reaching institutional reforms that should move beyond financial and technical imperatives. The CRC, pioneered by the Public Affairs Center (PAC), Bengaluru, is a simple but powerful tool to provide public agencies with systematic feedback from users of public services. CRC gains such feedback through sample surveys on aspects of service quality that users know best, and enable public agencies to identify strengths and weaknesses in their work. A CRC on public services is not just one more opinion poll; it reflects the actual experiences of people with a wide range of public services. The survey on which a report card is based covers only those individuals who have had experiences in the use of specific services, and interactions with the relevant public agencies.