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EFSP Utility Assistance Application


    Funding for this grant (EFSP) was made possible by Lumber River United Way. Please ensure that before starting the application you carefully read over the eligibility requirements. NO payments will be made directly to individuals; payments will be made to the utility vendor.

  2. ***Please read the EFSP Quick Reference and FAQ information linked below before Applying***

  4. Income Eligibility ****MUST ATTACH PROOF OF INCOME or SUMMARY BELOW****
  5. Certification

    The applicant of this form hereby attests that the name in which this application was completed in is also the registered customer at the listed physical address for the selected utility vendor. Applications must be completed in the name of the person who is listed as a customer by the utility.

  6. Citizens must attach original past-due cut-off/shut-off notice below.
  7. Leave This Blank:

  8. This field is not part of the form submission.