LIRA Application - Del Oro Water

LIRA Application Form

Notice and application for the 2021-22 Low Income Ratepayer Assistance Program STIRLING BLUFFS DISTRICT Application For Del Oro Water Company’s Low Income Ratepayer Assistance Program Primary Residential Customer

I am a primary residential customer of Del Oro Water Company (DOWC). Please indicate below:

Your name as shown on your Del Oro account(Required)

First Last

Address where you receive Del Oro water service(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Del Oro Account Number(Required)

Starts with 005

Primry Phone Number(Required)

Type(Required)

Secondary Phone Number

If Applicable

Type

Number of persons living in your household

*Please attach a copy of your PG&E bill showing CARE discount or other proof of income for eligibility verification By consenting below, I certify under penalty of perjury that this information is true and correct under the laws of the state of California. I will provide proof of income and I will notify Del Oro Water Company of any changes that affect my eligibility.

File

Max. file size: 50 MB.

Date(Required)

This field is hidden when viewing the form

SUBMISSION DATE

Our offices will be closed Monday Monday, May 26th, for the holiday. If you have any urgent issues, you can still call into your district for assistance.

LIRA Application Form