What information does the LIHWAP application ask for?

It asks about household members, income, housing, water-service status, and the utility company and account information for the requested grant.

Who should complete this water assistance application?

A household applying for LIHWAP water assistance should complete the questions about its members, income, housing, and water utility.

How do I submit the LIHWAP application?

The document does not provide a submission address or method. Submit it to the city department named on the form and check the city website for current contact details.

Do I need a notary for the LIHWAP application?

No. This application is signed and dated without a notary, and it does not identify an attachment or related step that must be notarized or sworn.

Sandy Lake, PA · Mercer County

No notary required

Low Income Household Water Assistance Program Application

This application lets households seeking water assistance provide household, income, housing, water-service, and utility-company information for the program.

What this form is

Use this application to apply for the Low Income Household Water Assistance Program. It asks for information about household members, income, housing, water-service status, and the utility company to receive a grant. Applicants must answer all questions on both sides and sign at the marked X; the form advises contacting the local county assistance office if instructions are unclear.

Who needs it

Households applying for water assistance should complete the application and provide information about household members, income, housing, and their water utility.

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; it does not identify any attachment or related step as requiring notarization or a sworn statement.

How to submit this form

1
Download the Application
Download the LIHWAP application for water assistance.
2
Complete the Questions
Answer all questions on both sides, including household, income, housing, water-service, and utility information.
3
Gather Additional Information
If your household has additional people, provide their information on a separate piece of paper and send it with the application.
4
Sign and Submit
Sign at the red X. Submit the application to the city department named on the form; check the city website for current contact details.

Frequently asked questions

What information does the LIHWAP application ask for?: It asks about household members, income, housing, water-service status, and the utility company and account information for the requested grant.
Who should complete this water assistance application?: A household applying for LIHWAP water assistance should complete the questions about its members, income, housing, and water utility.
How do I submit the LIHWAP application?: The document does not provide a submission address or method. Submit it to the city department named on the form and check the city website for current contact details.
Do I need a notary for the LIHWAP application?: No. This application is signed and dated without a notary, and it does not identify an attachment or related step that must be notarized or sworn.

Need something notarized?

This Low Income Household Water Assistance Program Application doesn’t need a notary — but if you have another Sandy Lake form that does, a commissioned online notary can help.