Low-Income Groot Discount Program

Low-Income Groot Discount Program
Groot's Low-Income Discount program is available for senior citizens age 65 or older and persons with disabilities, whose household income is less than $16,000 per year. If you match these required critera, please fill out the form below.

This discount does not apply to landscape waste stickers, the landscape waste subscription programs, or the Special Collection rates.

Contact the Village's Social Worker for Disability and Geriatric Services at 847-368-5793 for more information or to fill out an in-person application.

Please note that this program requires applicants to recieve a household income less than $16,000/year. If you are looking for a general Senior Citizen Discount for any residents over the age of 65, please visit the Groot Senior Citizen Discount Program.
Full Name*

First NameLast Name
Date of Birth*

MonthDayYear
Date
Full Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Please list other members of your household, their relationship to you, their date of birth, and age.*
Attach a copy of your last Groot bill showing your name, address, and account number
Copy of Recent Groot Bill *

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Groot Account Number *
Copy of Lease or Mortgage Statement *

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Attach a copy of the total household income for all individuals living in the home.

All that apply: 3 months pay stubs with length of pay period indicated OR current Disability, SSI/SSDI/Social Security Retirement, unemployment award letter OR W2 form OR tax return
Total Household Income*

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Driver's License OR State ID OR Birth Certificate*

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For Citizens with Disabilities Under the Age of 65

Attach a copy of your Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) award letter or a physicians certificate of disability, for proof of disability.

Attach one of the following
SSI or SSDI Award Letter OR Disability Certificate

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I certify that all the information contained in this application, with attachments, is complete and true.
Sign Here*

First NameLast Name
I agree to electronically sign and to create a legally binding contract between the other party and myself, or the entity I am authorized to represent.
Signature*
Should be Empty:

Low-Income Groot Discount Program

For Citizens with Disabilities Under the Age of 65

Attach a copy of your Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) award letter or a physicians certificate of disability, for proof of disability.

Attach one of the following

I certify that all the information contained in this application, with attachments, is complete and true.