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City of Freeborn Utility Billing Division 44 W. Hubble Avenue Freeborn, OH 45324 Phone: 937.754.3007 Fax: 937.754.3107___UTILITY SERVICE WAIVER In consideration of the City of Freeborn providing water,

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How to fill out utility service waiver

01

Obtain the utility service waiver form from the utility provider or online.

02

Fill in your personal information such as name, address, and contact details.

03

Indicate which services you are requesting a waiver for and the reason for the request.

04

Provide any supporting documentation or proof of eligibility if required.

05

Sign and date the utility service waiver form.

Who needs utility service waiver?

01

Individuals who are unable to pay for utility services due to financial hardship.

02

Tenants who are responsible for their own utility bills but are unable to afford them.

03

Low-income households or individuals receiving government assistance.

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What is utility service waiver?

A utility service waiver is a form that allows individuals to request an exemption from paying certain utility services.

Who is required to file utility service waiver?

Individuals who qualify for specific exemptions outlined by utility companies are required to file a utility service waiver.

How to fill out utility service waiver?

To fill out a utility service waiver, individuals must provide their personal information, details of the exemption they are requesting, and any supporting documentation required.

What is the purpose of utility service waiver?

The purpose of a utility service waiver is to provide financial relief to individuals who qualify for certain exemptions from paying utility services.

What information must be reported on utility service waiver?

Information such as personal details, exemption being sought, and any supporting documentation must be reported on a utility service waiver.

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