Sebastopol, CA · Sonoma County
Water Bill Assistance Application (Spanish)
Spanish-language application for households seeking Low-Income Household Water Assistance Program benefits to help pay water or wastewater costs.
What this form is
This Spanish-language packet lets a household apply for LIHWAP assistance with water or wastewater costs. It asks for applicant and household details, income, utility account and bill information, and a signature; it also includes a landlord agreement and an income-and-expense certification. The instructions call for a current water bill showing an overdue balance, proof of income and energy costs, and other documents based on the applicant’s circumstances.
Who needs it
Households seeking LIHWAP assistance for water or wastewater costs can use this application and provide the supporting documents listed in its instructions.
How to submit it
The instructions say to return the application to North Coast Energy Services, Inc., at 1100 Coddingtown Center, Santa Rosa, CA 95401, or apply online at www.nces.org.
About notarization
This packet does not require notarization; the applicant signs and dates the application, and any applicable landlord agreement or income-and-expense certification is also signed and dated.
How to submit this form
- 1
Download The Application
Download the Spanish-language LIHWAP application packet.
- 2
Complete The Application
Fill in applicant and household details, income information, utility account information, and the requested bill details.
- 3
Gather Supporting Documents
Include the current water bill and required income and energy-cost proof; complete the landlord agreement if water is included in rent.
- 4
Submit The Application
Return it to North Coast Energy Services at 1100 Coddingtown Center, Santa Rosa, CA 95401, or apply online at www.nces.org.
Frequently asked questions
- Do I need a notary for the Water Bill Assistance Application?
- No. The packet does not require notarization. The applicant signs and dates the application; any applicable landlord agreement or income-and-expense certification is also signed and dated.
- How do I submit the Water Bill Assistance Application?
- The instructions list North Coast Energy Services, Inc., at 1100 Coddingtown Center, Santa Rosa, CA 95401, for Sonoma County, and also say you can apply online at www.nces.org.
- What documents should I include with the application?
- The instructions request a current water bill showing an overdue balance, proof of income and energy costs, and supporting verification documents. If water is included in rent, the packet includes a landlord agreement.
- What information does the application request?
- It asks for applicant and household information, household income, utility account details, information about the bill and service, and the applicant’s signature.