Virden, IL · Macoupin County
Application for Senior Water Rate
Virden residents age 62 or older can use this application to request the city’s senior water rate based on household income.
What this form is
This application lets a Virden resident age 62 or older request the city’s senior water rate. It asks for the applicant’s date of birth and annual income, with listed income limits for one- and two-person households; applicants agree to notify the Water Department if their income changes.
Who needs it
A Virden resident age 62 or older who wants to apply for the senior water rate can complete this application.
How to submit it
Submit it to the city department named on the form; check the city website for current contact details.
About notarization
This application is signed and dated without a notary; the form lists no notarized attachment or sworn step.
How to submit this form
- 1
Download The Application
Download the senior water rate application.
- 2
Complete The Form
Enter your date of birth and annual income, then sign and date the application.
- 3
Review Attachments
Check the form for any required attachments; none are listed.
- 4
Submit To The City
Submit the application to the city department named on the form; check the city website for current contact details.
Frequently asked questions
- Who can apply for Virden’s senior water rate?
- The form is for a resident of Virden who is age 62 or older. It also asks applicants to report annual income and household size.
- What information does the application ask for?
- It asks for the applicant’s date of birth and annual income, and lists income limits for one- and two-person households. The applicant must sign and date the form.
- Do I need a notary for the senior water rate application?
- No. This application is signed and dated without a notary, and the form lists no notarized attachment or sworn step.
- How do I submit the senior water rate application?
- The form does not give submission instructions. Submit it to the city department named on the form; check the city website for current contact details.