Application for Utility Assistance

  • Application for Utility Assistance

    Required documents must be uploaded directly for on-line applications. If you do not have access to a Full and Complete Monthly Bill - Please contact your utility company to request a copy.

  • Utility Assistance Policy

    Must live in CCF Service Area (Sapulpa, Kellyville, Kiefer and Eastern Creek County). Assistance amount is up to $100 / per household / per 12 months. Bill must be in your name and current address (or in the name of a current member of your household). We are unable to assist with deposits or balances from a previous address. In order to process requests, applicants must meet eligibility requirements and submit proper documents. It generally takes between 1-3 business days for CCF to issue a pledge. CCF makes financial pledges and sends payments directly to the utility company.
  • This is an application for Emergency Utility Assistance. CCF requires an actual full and complete month's billing statement from the utility company. The Due Date or Cut-Off Date may NOT be more than 48 hours from Today. Do you understand that your application will not be processed without a full and complete bill that is past due or due within the next 48 hours?*
  • Date
     - -
  • Assistance is limited to Eastern Creek Co., Sapulpa, Kellyville, and Kiefer. Where do you live (Service Address on the Utility Bill)?*

  • Personal Information

  • What gender do you identify as?
  • What race of ethnicity do you identify as?
  • Format: (000) 000-0000.

  • Household Information

  • Has anyone in your household, including yourself, served on active duty in the U.S. Armed Forces?
  • Is anyone in the household currently receiving SNAP/Food Stamps?
  • Does anyone in your household, including yourself, have a disability?
  • What is your living situation, today?
  • In the last month, did you or anyone in your household work for pay full-time?

  • Documentation

  • I understand that I must submit all of the required documents (*) to complete my application and that my application may not be processed or approved without a full and complete bill that is past-due bill or due within 48 hours from today*
  • Is the Bill in your name and current address?*
  • Is the Bill in the name of someone currently living at that address?*
  • Browse Files
    Drag and drop files here
    Choose a file
    Cancelof
  • Browse Files
    Drag and drop files here
    Choose a file
    Cancelof
  • Browse Files
    Drag and drop files here
    Choose a file
    Cancelof
  • Browse Files
    Drag and drop files here
    Choose a file
    Cancelof

  • Applications must be complete and include the proper documentation. It generally takes between 1-3 business days for us to process your application. If the application is approved, we will contact the utility company to issue a pledge. Payment will mailed directly to the utility company.

  • Should be Empty: