Long Beach, WA · Pacific County
Low Income Senior Utility Discount Application
This application requests a reduced utility base charge for eligible low-income senior customers and is filed with the City of Long Beach by a qualifying homeowner or renter.
- licensed online notary
- ~15 min average
- Notarized PDF emailed
What you’ll need
- Government-issued photo ID
- Webcam-enabled device (laptop or phone)
- This form, ready to upload as a PDF
What this form is
The application requests a discount on the base charge for City water, sewer, and storm water utilities. It is for eligible customers age 65 or older who meet the income and residency requirements; renters may apply, but their property owner must complete and notarize the owner statement. Applicants must reapply annually and present income documentation in person to the City.
Who needs it
A Long Beach utility customer age 65 or older who meets the stated income and residency requirements may apply; a renter must also have the property owner complete the owner statement.
Why it needs a notary
The form contains an acknowledgment before a notary public in the property owner section; the property owner signs that statement before the notary.
How to get this notarized
- 1
Download the Application
Get the Low Income Senior Utility Discount Application from the City of Long Beach.
- 2
Complete the Application
Fill in the customer, household, account, and income details. Have the property owner complete the owner statement if the applicant is a renter.
- 3
Book an Online Notary
If the property owner needs the statement notarized, book an appointment with a commissioned online notary.
- 4
Sign on Video
The property owner signs the owner statement during the online notary session and completes the acknowledgment.
- 5
Submit to the City
Return the application to the City of Long Beach and present the required income documentation in person.
Preview the form
The blank PDF straight from Long Beach. Look it over, then upload your filled copy to start the notary session.
You’ll need ID and a webcam.
A licensed online notary will join you on video, verify your government-issued ID, witness your signature, and apply their seal. You’ll receive the notarized PDF by email when the session ends.
Frequently asked questions
- How do I apply for the senior utility discount?
- Complete the application, provide the requested income information and supporting documents, and return it to the City of Long Beach. The form says income documents must be presented in person.
- Do I need a notary for this application?
- The property owner section includes an acknowledgment before a notary. The property owner signs that statement before the notary; the form does not show a notary block for the senior customer.
- Can a renter apply for the discount?
- Yes. The form includes renters, but says the property owner must complete the owner portion and sign the statement. The discount is intended to assist the renter, not the owner.
- Can I sign the property owner statement online with a notary?
- Washington authorizes its notaries to perform remote online notarizations under RCW 42.45.280, and an authorized out-of-state notarial act has the same effect under RCW 42.45.090. Confirm with the city or town if unsure.