LOW INCOME UTILITY CREDIT APPLICATION

LOW INCOME UTILITY CREDIT APPLICATION
Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
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Email
example@example.com
By signing this form I certify that:

I am applying for the City of Fircrest Low Income Utility Fee Credit.

If approved, the credit will begin on the first day of the current bi-monthly billing cycle after the application is approved by the City of Fircrest.

I currently reside at the above property location.

I am currently receiving a Tacoma Public Utilities (TPU) low-income discount, and

I have provided a copy of my most recent Tacoma Power bill showing that I am currently receiving their low-income discount.
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