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Income-Qualified Programs Application: Energy Discount Program for Senior, Long-Term Disabled, or Military Veteran Customers Green Power Program

  1. Applicant Information:

  2. What is Your Preferred Language for Communication?

  3. Program (Select One):

  4. Are you:

  5. Are you the customer of record or listed as a responsible party on the account?

  6. Household Information

  7. Head of Household

  8. ...

  9. A) Current Living Status

  10. Do you own or rent?

  11. Do you Own or Rent?

  12. Please Enter the Name of Your Mobile Home Park

  13. Is your Mobile Home unit individually metered for electric use?

  14. Do you receive your electrical bill from park management?

  15. Authorization from mobile home park owner/manager to receive Income-Qualified Energy Discount at master meter and provide savings directly to qualified senior:

  16. ...

    Energy Discount Program Qualifications:
    Senior, long-term disabled, or military veteran customers are eligible for a maximum of 10% discount on electric charges of the Utility Bill. If you already receive the senior/longer-term disabled/military veteran Energy Discount, you cannot apply for an additional 10% credit. If you are claiming a disability, you must attach a copy of your latest SSI statement or a letter from your physician in order to obtain the energy credit and must be listed as a Responsible Party on the electric account. You must attach a copy of identification proving your age is at least 62 years old to be eligible as a senior or a copy of either a DD-214, Veteran Health Identification Card (VHIC), or Common Access Card to be eligible as a military veteran. Please allow at least 30 days for processing and activation of your energy discount. Upon approval, you will receive the energy credit on your next billing cycle.

    Solar Program Qualifications:
    Program participation shall be granted on a first-come first-served basis based on the date that a completed application is received by the Utility, limited to the amount of solar energy derived from Utility-owned solar facilities located on public school sites, limited to the expected output of such solar facilities divided by 200 kWh per month. Due to the limited amount of solar energy available from such facilities as compared to the potential number of income-qualified Customers, the available solar energy shall be allocated to Program participants for a period not to exceed six (6) months ("Participation Period"). Customers will automatically be taken off the Program at the end of the Participation Period; however, Customers may reapply for the Program one-year from initial participation to participate for another Participation Period.

    IMPORTANT NOTE: In order to qualify for the Energy Discount or Solar Program you must be income qualified and listed as a responsible party, (must be at least 18 years of age) on the Anaheim Public Utilities electric account. Customers can only participate in one Program. Please review application to make sure it is complete. By signing this application, you are certifying that all information you have provided is accurate and complete. You are certifying that you have accurately reported your income and your legal residence. Participation in a Program is voluntary.

  17. Agreement:*

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  19. This field is not part of the form submission.