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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. July 5, 2022
Application checklist PDF Use this checklist to make sure you're ready to complete the application for water bill assistance. January 28, 2022
Sample Application PDF Use this as reference to help plan your application for water bill assistance before you start. February 2, 2022
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
Water bill assistance flyer (Haitian Creole) PDF Print this flyer to share with community members or constituents June 8, 2022
Water bill assistance flyer (Simplified Chinese) PDF Print this flyer to share with community members or constituents June 8, 2022
Water bill assistance flyer (Spanish) PDF Print this flyer to share with community members or constituents. June 8, 2022
Water bill assistance flyer (Traditional Chinese) PDF Print this flyer to share with community members or constituents June 8, 2022
Water bill assistance flyer (Vietnamese) PDF Print this flyer to share with community members or constituents 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
TAP Debt Forgiveness fact sheet (SPANISH) PDF Learn how you can clear your water bill debt when you are enrolled in the Tiered Assistance Program. September 28, 2021
Water Customer Assistance Programs Eligibility Guidelines PDF These are the guidelines used to determine and enroll you in the program that provides the lowest bill. January 28, 2022
Water Customer Assistance Programs Eligibility Guidelines (Spanish) PDF Learn how to tell if you are eligible for a Water Customer Assistance Program. January 28, 2022

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