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Water bill customer assistance application and documents

Use these documents to plan your water bill customer assistance application. If you need in-person help with your application, find a help location near you.

Name Description Released Format
Medical Certification Form PDF This form must be completed by a physician, nurse practitioner or physician’s assistant for customers who must maintain water service due to a medical emergency. August 25, 2022
Formulario de certificación médica PDF Este formulario debe ser completado por un médico, enfermero practicante o asistente médico para clientes que deben mantener el servicio de acueductos debido a una emergencia médica. January 9, 2023
Water Customer Assistance Fact Sheet PDF Takeaway sheet with details about water customer assistance including TAP and Senior Citizen Discount January 23, 2023
Application checklist PDF Use this checklist to make sure you're ready to complete the application for water bill assistance. January 27, 2023
Lista de comprobación de la solicitud PDF Use esta lista de verificación para asegurarse de que está listo para completar la solicitud de asistencia para la factura del agua. August 18, 2022
Sample Application PDF Use this as reference to help plan your application for water bill assistance before you start. January 27, 2023
Water bill assistance flyer PDF Print this flyer to share with community members or constituents January 3, 2022
Water bill assistance flyer (French Creole) PDF Print this flyer to share with community members or constituents. June 8, 2022
Depliyan èd pou bòdwo dlo PDF Enprime deplyan sa a pou w pataje avèk manm kominote a oswa elektè yo June 8, 2022
水费账单援助计划宣传单 PDF 打印此宣传单,并与社区成员或选民分享 June 8, 2022
Folleto de ayuda con la factura del agua PDF Imprima este folleto para compartir con los miembros de la comunidad o los electores June 8, 2022
水費賬單援助計劃宣傳單 PDF 打印此宣傳單,並與社區成員或選民分享 June 8, 2022
Tờ rơi về hỗ trợ hóa đơn tiền nước PDF In tờ rơi này để chia sẻ với các thành viên hoặc cử tri trong cộng đồng June 8, 2022
Folleto: Ayuda con su factura del agua PDF Imprima este folleto sobre ayudas con la factura del agua, y compártala con vecinos y miembros de su comunidad August 12, 2021
TAP Debt Forgiveness fact sheet PDF Learn how you can clear your water bill debt when you are enrolled in the Tiered Assistance Program. July 28, 2022
Hoja de información sobre la condonación de deuda TAP PDF Infórmese cómo puede pagar su factura del agua cuando está inscripto en el Programa de Asistencia por Niveles, TAP. September 27, 2022
Water Customer Assistance Programs Eligibility Guidelines PDF Use this checklist to make sure you're ready to complete the application for water bill assistance. January 27, 2023
Directrices de elegibilidad de los programas de ayuda al usuario del agua PDF Infórmese como saber si es apto para participar del programa de ayuda al usuario del agua. January 27, 2023

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