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Application for Disconnection protection inability to pay Declaration form if you are unable to pay your bills in full and need cold Weather protection from utility disconnection, complete this form
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How to fill out application for disconnection protection

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How to fill out application for disconnection protection

01
Step 1: Gather all necessary information and documents required for the application for disconnection protection.
02
Step 2: Contact your utility company and inquire about the specific process and requirements for application submission.
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Step 3: Obtain the application form either from the utility company's website or from their customer service representative.
04
Step 4: Fill out the application form accurately and completely. Provide all the necessary details such as your name, address, account number, and contact information.
05
Step 5: Attach any supporting documents required by the utility company, such as income statements, proof of financial hardship, or medical certificates if applicable.
06
Step 6: Review the completed application form to ensure all information is correct and all necessary documents are attached.
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Step 7: Submit the application form and supporting documents to the designated office or department of the utility company.
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Step 8: Follow up with the utility company to confirm that they have received your application and to inquire about the expected timeline for a decision.
09
Step 9: Await the utility company's decision regarding your application for disconnection protection. They may contact you for additional information if needed.
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Step 10: If your application is approved, make sure to comply with any conditions or requirements set by the utility company to maintain the disconnection protection.
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Step 11: If your application is denied, you may have the option to appeal the decision or explore other assistance programs that may be available.

Who needs application for disconnection protection?

01
Individuals or households facing financial hardship and struggling to pay their utility bills.
02
People who are at risk of disconnection of essential utilities such as electricity, water, or gas.
03
Low-income households or individuals who meet the eligibility criteria set by the utility company for disconnection protection.
04
Individuals with medical conditions that require continuous access to utilities for health and safety reasons.
05
Families with young children, elderly individuals, or individuals with disabilities who would face significant hardship if disconnected from essential utilities.
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