Income Qualification
Based on PG&E CARE program income limits and updated each fiscal year accordingly once PG&E posts the applicable income limits for the Current Fiscal Year.
Household Size Total Gross Annual Income
1-2 Persons $43,280
3 Persons $54,640
4 Persons $66,000
5 Persons $77,360
Each additional person, add $11,360
Application
If you are eligible and would like to participate, Submit PG&E bill showing enrollment in the CARE program or other proof of income required by this application along with the completed application to:
Estero Municipal Improvement District
Water/Wastewater Rate Assistance Program (W/WRAP)
610 Foster City Boulevard
Foster City, CA 94404
Estero Municipal Improvement District
Water/Wastewater Rate Assistance Program (W/WRAP)
Program Description
The W/WRAP is intended to provide rate relief to eligible and qualified account holders who demonstrate need by providing up to $15 per month each on their qualifying Water and Wastewater accounts, not to exceed a $30 per month discount per customer. In no case shall the discount exceed the amount of the monthly bill.
A copy of a PG&E bill showing enrollment in the CARE rate assistance program along with this completed application will qualify applicants for the W/WRAP program. Customers who do not participate in CARE can qualify by submitting the application and other documentation of income identified in this application. Once the application is processed and the account is enrolled, the discount will automatically appear on the following month’s bill.
Program Qualification
To qualify for the discount, you must meet the following requirements:
The bill must be in your name.
You must reside at the address to which the discount applies. Your home may not share a water meter.
Another person (besides your spouse) may not claim the applicant as a dependent on an income tax return.
You must demonstrate that you meet the eligibility requirements and attach proof of eligibility.
The account must be in good standing.
APPLICATION FOR WATER/WASTEWATER
RATE ASSISTANCE PROGRAM (W/WRAP)
(Please type or print legibly)
1 I am a primary residential customer of Estero Municipal Improvement District
(Application must be in the account holder’s name)
______________________________________
Name as shown on your EMID account
_______________________________________
Address where you receive water service
-
EMID Account Number (11 digits)
Daytime Phone: __________________________
Email Address: ____________________________
# of Adults: _________ of Children: _________
Total residents in household: _______________
2A Public Assistance Program Eligibility
CHECK all programs you participate in, then GO TO section 3 PG&E’s CARE program
Medicaid/Medi-Cal (age 65 and older)
SSI
Food Stamps/SNAP
LIHEAP
WIC
Healthy Families A & B
TANF or Tribal TANF
NSL FREE Lunch Program
Bureau of Indian Affairs General Assistance
Head Start Income Eligible (Tribal Only)
If you do not participate in any of the above programs, GO TO section 2B
2B Household Income Eligibility
Check all sources of household income.
Pensions
Social Security
SSP, SSDI
Interests/Dividends from: Savings Accounts, Stocks, Bonds or Retirement Accounts
Wages and/or Profits from Self-Employment
Rental or Royalty Income
Unemployment Benefits
Disability or Workers Compensation Payments
Scholarships, Grants or Other Aid for Living Expenses
Insurance or Legal Settlements
Spousal or Child support
Cash and/or Other Income
Total Annual Household Income
$ ,
3 Declaration (Read and Sign)
I state that the information I have provided in this application is true and correct. I agree to provide proof of income if asked. I agree to inform EMID if I no longer qualify to receive the discount. I understand that if I receive the discount without qualifying for it, I may be required to pay back the discount I received. I understand that EMID can share my information with other utilities or their agents for the purpose of enrolling me in their assistance programs.
X
Customer Signature Date
CITY APPROVAL
Public Works reviewed by Public Works approved by
Finance reviewed by Finance approved by