About Your Household
A “household” means the person(s) who occupy a housing unit and contribute to the household.
Situations not considered to be contributing to a household:
- Minor dependents under the age of 18 count towards your household size but their income is not counted towards household income.
- Registered in-home caregivers do not count towards household size or household income.
- Renters in your home do not count towards household size or income: however, you must include any rental income to your household income.
I, the undersigned, under penalty of perjury of the laws of the state of Washington do hereby declare and certify:
- That I have read and understood all of the Utility Bill Assistance Program Guidelines for Emergency Assistance/ Neighbors Helping Neighbors provided with this application, and that all of the information provided by me on this application is accurate, complete, and true to the best of my knowledge.
- That I understand that submitting the required documentation does not guarantee eligibility to the program. Such information will, however, be used to determine if I qualify for benefits under the program.
- That I understand that the income documents I provided will be used by the City to create an income worksheet that will be used to determine income qualification.
- That I have read the definition of “disposable income” for the program and to the best of my knowledge, I and my household are eligible for the program.
- That I have provided a true and accurate list of “disposable income” to the City for the last 30 days.
- That I understand the 100% rate reduction on basic utility service charges is for four (4) months only and that I am eligible for this program once every three (3) years (Emergency Assistance).
- That I understand the 100% rate reduction on basic utility service charges is for two (2) months only and that I am eligible for this program once every year (Neighbors Helping Neighbors).
- That I understand that any attempt to falsify my information will result in my disqualification from the program for this year and may subject me to repayment of benefits received and to civil or criminal penalties.
- That I understand the City reserves the right to audit my records to determine my eligibility for the program.
- That I understand that if I receive utility assistance and do not disclose all sources of disposable income for household members during the last 30 days, the City may recover the actual cost of my utility bills for the period that I was not eligible.
