Who can apply for the senior water and sewer rate reduction?

Applicants must be at least 65 during the year they file, have Ohio adjusted income of $40,000 or less, and live in a rental unit served by Smithville’s water and sewer system.

What information and evidence does the application request?

The form asks for applicant and spouse details, the rental address, utility billing account number, and filing date. It requests evidence of age and income, including a copy of proof of age.

Do I need a notary for the senior rate reduction application?

No. The application has signature and date fields but no notary block. The signer declares under penalty of perjury that the information is true, correct, and complete.

Smithville, OH · Wayne County

No notary required

Application for Water & Sewer Rate Reduction for Senior Citizens

Smithville seniors in eligible rental units use this application to request a reduction in their water and sewer rates.

What this form is

The application requests a water and sewer rate reduction for qualified seniors who live in a Smithville rental unit served by the Village’s water and sewer system. Applicants must be at least 65 during the year they file and have Ohio adjusted income of $40,000 or less. The form asks for applicant and spouse details, rental and utility account information, age and income evidence, and signed declarations.

Who needs it

Seniors who meet the age and income requirements and rent a unit served by Smithville’s water and sewer system can apply.

How to submit it

Submit it to the city department named on the form; check the city website for current contact details.

About notarization

The signer signs and dates the application without a notary, declaring under penalty of perjury that the information is true, correct, and complete.

How to submit this form

1
Download The Application
Download the Smithville senior water and sewer rate reduction application PDF.
2
Complete The Applicant Details
Enter applicant and spouse information, rental address, utility account number, and application date.
3
Gather Supporting Evidence
Provide evidence of age and income, including a copy of proof of age as indicated on the form.
4
Sign And Submit
Sign and date the declarations, then submit the application to the city department named on the form.

Frequently asked questions

Who can apply for the senior water and sewer rate reduction?: Applicants must be at least 65 during the year they file, have Ohio adjusted income of $40,000 or less, and live in a rental unit served by Smithville’s water and sewer system.
What information and evidence does the application request?: The form asks for applicant and spouse details, the rental address, utility billing account number, and filing date. It requests evidence of age and income, including a copy of proof of age.
Do I need a notary for the senior rate reduction application?: No. The application has signature and date fields but no notary block. The signer declares under penalty of perjury that the information is true, correct, and complete.
How do I submit the senior rate reduction application?: The form does not state how to submit it. Submit it to the city department named on the form; check the city website for current contact details.

Need something notarized?

This Application for Water & Sewer Rate Reduction for Senior Citizens doesn’t need a notary — but if you have another Smithville form that does, a commissioned online notary can help.