Altavista, VA · Campbell County
Residential Utility Discount Program Application
Altavista residential utility account holders use this application and financial statement to request a discount on qualifying quarterly water and sewer bills.
What this form is
The Town of Altavista uses this annual application to determine whether residential utility account holders qualify for a 30% discount on the base rate fee of their quarterly water and sewer bill. Applicants provide household and utility account information, income and asset details, and supporting documents. The form describes age, income, and net worth criteria, with an exception for applicants who are permanently and totally disabled.
Who needs it
Altavista residential utility account holders seeking the discount must apply annually and provide the application, financial statements, and required supporting documents.
How to submit it
Mail the application to Town Hall at P.O. Box 420, 510 Seventh Street, Altavista, VA 24517, or drop it off at Town Hall or in its drop box.
About notarization
This document is signed without a notary; the applicant and spouse sign and date the application, and no attachment or related step is identified as notarized or sworn.
How to submit this form
- 1
Download The Application
Download the application and its financial statement worksheet.
- 2
Complete The Forms
Enter applicant, household, and utility account details, then complete the financial statements.
- 3
Gather Supporting Documents
Include copies of household income records and a recent bank statement for each bank account.
- 4
Submit To Town Hall
Mail the application to Town Hall or drop it off there or in the Town Hall drop box.
Frequently asked questions
- Who can apply for the Altavista utility discount?
- Residential utility account holders may apply if they meet the program's age, household income, and net worth criteria. A permanently and totally disabled applicant may qualify without meeting the age requirement.
- What documents should I include with my application?
- The document requests completed financial statements, copies of household income documents such as W-2 and 1099 statements, and a recent bank statement for each bank account. A disability letter is required for the age exception.
- How do I submit the utility discount application?
- Mail it to Town Hall at P.O. Box 420, 510 Seventh Street, Altavista, VA 24517, or drop it off at Town Hall or in its drop box.
- Do I need a notary for the utility discount application?
- No. The applicant and spouse sign and date the application; the document does not identify any attachment or related step as requiring notarization or a sworn statement before a notary.