Berwick Electric Relief Fund

Berwick Electric Relief Fund Application

Assist with electric bill support
STEP 1: Applicant Information

Please provide details as they appear on your Berwick Electric account.
Full Name*

First NameLast Name
BEC Account Number*
Civic/Delivery Address*

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Mailing Address (if different from above)

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Home Phone
Please enter a valid phone number.
Cell Phone
Please enter a valid phone number.
Email Address*
example@example.com
STEP 2: Reason for Request

Describe your reason for applying and the amount of support you are requesting (maximum $400).
Please describe why you are applying for assistance.*
Amount of support requested (maximum $400)*
STEP 3: Consent to Verify Information

By signing below, you acknowledge that the information provided is accurate and complete. You authorize the Relief Fund to access your Berwick Electric account.
Applicant Name*
Date*

MonthDayYear
Date
Signature*

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STEP 4: Submission Instructions

Submit your completed application to by clicking the submit button below, email to electricgrant@berwick.ca or deliver to: Berwick Electric Relief Fund, c/o Berwick Town Hall, 236 Commercial St., Berwick NS B0P 1E0. A secure drop box is also available at Town Hall.
For Office Use Only

This section is to be completed by the Berwick Electric Commission.
Date application received

MonthDayYear
Date
Amount received ($)
Applicant's previous bill (notes)
Has the applicant been in arrears in the past 12 months?

YesNo
Is the applicant currently in arrears?

YesNo
Amount of arrears ($)
Date application reviewed

MonthDayYear
Date
Date of approval

MonthDayYear
Date
Date applicant was notified

MonthDayYear
Date
Date cheque was sent to BEC

MonthDayYear
Date
Should be Empty:

Berwick Electric Relief Fund Application

STEP 1: Applicant Information

STEP 2: Reason for Request

STEP 3: Consent to Verify Information

STEP 4: Submission Instructions

For Office Use Only