Utility Assistance Google Form

If you find yourself behind on your utility bills, and fall within income guidelines, local assistance programs may be able to help.

Please complete the following form to apply online through Nampa Shares and Cares (for assistance with City of Nampa: Water, Sewer, Trash). Be sure to read the description for each question.

This is an ONLINE process - Please check your email for further instructions.

If you have any questions, feel free to email projectshare.nampa@usw.salvationarmy.org.

HAVE A BLESSED DAY!

This application is for City of Nampa: Water, Sewer, Trash Only. If you need assistance with your Power or Natural Gas bill please apply at the following link: Project Share - Power and Natural Gas

NOTICE: If all required documentation is not received within 3 business days of application submission or request for additional documentation, your application will be terminated. Please submit the required information at the time of applying for the quickest review time.

ADDITIONALLY: Please check your "spam" or "junk" email folders before contacting our office. This is an online process and we will communicate with you using the email address provided on this form.

Email*

example@example.com

Applicant's Full Name*

Please enter the full name as it APPEARS ON THE BILL

Please upload your Driver's License or Identification Card*

Applicant's Date of Birth*

MM-DD-YYYY

MaleFemaleOther or Applicant Prefers Not to Answer

Are you over age 62?*

Applicant Address*

For water assistance, the client must live in the City of Nampa. If you live outside of our service area, call (208) 365-3116 to find a location near you.

Applicant Phone Number *

I agree

Income*

Proof of Income (at least 30 days)*

Acceptable forms of income verification include, but are not limited to the following. Please submit at least one of the options below, and all the documents that pertain to the income of the entire household:

Paystubs (most recent 30 days)
Health & Welfare benefit letter
Social Security benefit letter
SSI - Supplemental Security Income benefit letter (retirement, disability, survivors, and supplemental)
Worker's Compensation
Pension
Unemployment benefit letter
Bank statements (most recent 30 days - all pages, including blank pages)
Any document reflecting additional income for the household.

Other Resources*

List any other agencies you have already talked to and what the outcome was.

Nampa: Water

Please upload the front and back of all pages of your bill.*

Account Number*

Please enter your account number.

YesNo

If not, how long have you been living in the City of Nampa?*

Please enter number of months or N/A is not applicable.

YesNo

How many OVER the age of 18 live in your household?*

How many UNDER the age of 18 live in your household?*

YesNo

Gross Income*

Please enter the MONTHLY gross income (income before taxes) for the ENTIRE household for the PREVIOUS month. For example, Employment, SSI (Supplemental Security Income), Social Security (retirement, disability, survivors, and supplemental benefits), Workers Compensation, Pension, Unemployment payments, TAFI and TANF assistance.

Past Due Amount*

Please enter the past due amount of your bill. The bill must be past due for Nampa Shares and Cares to assist.

Due Date*

Please enter the date that your bill is due.

Nonpayment due to?*

Please explain why you are unable to pay the bill at this time.

Good Faith Effort*

Please list what efforts you have made to make a payment on your bill. For example, reaching out the utility company about payment arrangements or have recently made a partial payment?

I understand

Please list ALL additional people living in your household, including their full name and date of birth. (This information is REQUIRED to process your application.)*

I understand

YesNo

Electronic Signature: Please acknowledge your consent by entering your name in the space provided. Doing so certifies the above statements are true and correct to the best of your knowledge. A false statement may disqualify you for utility benefits. THANK YOU. *

The Salvation Army of Nampa Utility Assistance Application for the Nampa Shares and Cares program - City of Nampa: Water, Sewer, Trash