Sebastopol, CA · Sonoma County
Water Assistance Program Application – English
This application lets households apply for Low-Income Household Water Assistance Program benefits to help pay water or wastewater costs.
What this form is
Households use this application to request assistance with water or wastewater costs. The packet asks for household, income, utility account, and service-address details, and requires proof of income and energy costs covering the past 30 days, plus a current water bill showing a past-due balance. If water is included in rent, the packet includes a landlord or management agreement.
Who needs it
Households seeking water or wastewater bill assistance can apply and provide the required identity, household, income, and utility information.
How to submit it
Apply online at www.nces.org or return the application to North Coast Energy Services, Inc., 1100 Coddingtown Cir, Santa Rosa, CA 95401. The packet lists (707) 495-4417 for Sonoma County.
About notarization
This document is signed without a notary; the applicant declares the application true under penalty of perjury, and the included landlord agreement and income certification require signatures and dates.
How to submit this form
- 1
Download The Application
Download the Water Assistance Program Application packet.
- 2
Complete The Application
Fill in the applicant, household, income, and utility information, then sign and date the application.
- 3
Gather Required Documents
Include photo identification, a current water bill showing a past-due balance, and income verification; add the landlord/management agreement if water is included in rent.
- 4
Submit The Application
Apply online at www.nces.org or return the application to North Coast Energy Services, Inc. in Santa Rosa.
Frequently asked questions
- Do I need a notary for the Water Assistance Program Application?
- No. The applicant signs and dates the application, which includes a declaration under penalty of perjury; the included landlord agreement and income certification also require signatures and dates, not notarization.
- How do I submit the Water Assistance Program Application?
- Apply online at www.nces.org or return the application to North Coast Energy Services, Inc., 1100 Coddingtown Cir, Santa Rosa, CA 95401.
- What documents should I include with the application?
- The checklist asks for photo identification, a current water bill showing a past-due balance, and income verification for every adult covering the past 30 days. If water is included in rent, include the landlord/management agreement.