Aps E 3 Form PDF Details

Finding avenues to ease the financial burden of utility bills is crucial for many households, and the APS Energy Support Program (E-3) serves as a beacon of hope for eligible Arizona residents. Designed to assist individuals and families by providing a reduction in their electric bills, this program sets forth specific criteria aimed at identifying those in dire need of financial assistance. Among the prerequisites, applicants must be residential customers of APS with the account registered in their name, and their household income should not exceed the designated thresholds based on the number of occupants. This approach ensures that the assistance reaches those whose earnings fall below a certain level, making it essential for applicants to accurately report their total gross monthly income. With stipulated income brackets ranging from a single-person household to one with ten or more members, the program meticulously outlines the eligibility criteria while emphasizing the importance of providing complete and verifiable information. Additionally, by necessitating applicants' authorization for APS or its designated third parties to verify the provided details, the program underscores the integrity of the application process. Nevertheless, the stern warning against fraudulent claims highlights the legal and financial repercussions of deceit, ensuring only legitimate beneficiaries avail of the program's benefits. Thus, this thoughtful amalgamation of assistance and accountability characterizes the APS E-3 form as not just an application but a gateway to much-needed support for qualifying residents of Arizona.

QuestionAnswer
Form NameAps E 3 Form
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namesaps com assistance, aps energy support program, aps low income energy assistance, aps e 3 application form

Form Preview Example

APS ENERGY SUPPORT PROGRAM

To qualify for a reduction under the APS Energy Support Program (E-3), you must meet all of the following statements:

I am an APS residential customer and the APS bill is in my name.

My household income is at or below the income level in the listing below

(be sure to enter your household’s total gross monthly income in the box below).

Household

Monthly

Household

Monthly

Size

Income Level

Size

Income Level

 

 

 

 

1 person

$1,396

6 people

$3,871

 

 

 

 

2 people

$1,891

7 people

$4,366

 

 

 

 

3 people

$2,386

8 people

$4,861

 

 

 

 

4 people

$2,881

9 people

$5,356

 

 

 

 

5 people

$3,376

10 people

$5,851

 

 

 

 

For more than 10 people, add $495 per person (example: 11 = $6,346).

Please print the following information. INCOMPLETE INFORMATION WILL DELAY YOUR REDUCTION. The name used here to apply for the reduction MUST be the same as the name on the APS bill.

PLEASE PRINT LEGIBLY

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

APS ACCOUNT NUMBER (AS SHOWN ON APS BILL)

 

 

 

 

 

 

 

 

 

(MUST BE FILLED IN)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

TOTAL NO. OF

 

 

HOUSEHOLD’S

 

 

 

 

HOME TELEPHONE NUMBER

PERSONS LIVING

 

 

TOTAL GROSS

 

 

 

 

(

)

 

 

 

 

IN HOUSEHOLD:

 

 

MONTHLY INCOME: $

 

 

 

 

 

 

 

 

NAME AS SHOWN ON APS BILL (LAST, FIRST, M.I.)

MAILING ADDRESS (NUMBER AND STREET)

CITY

STATE

ZIP CODE

 

 

 

Permission is hereby granted to APS or a third party designated by APS to contact any sources necessary to

establish the accuracy of information given by me or other information which pertains to the veriication of

my eligibility to receive services under the APS Energy Support Program (E-3). Permission is also granted to a third party authorized by APS to exchange the information that I have provided. If the information provided on this form is false and used to fraudulently obtain a reduction under this program, I will be required to repay the reduced amounts.

Signature

 

Today’s Date

 

 

 

 

NOTE: Application must be signed by THE PERSON WHOSE NAME APPEARS ON THE APS BILL.

Please allow 30–45 days for processing.

GUIDELINES EFFECTIVE JULY 1, 2012. For current income guidelines, visit aps.com/e3.

Mail completed form to:

Arizona Public Service

APS Energy Support Program (E-3)

P.O. Box 2907

Phoenix, AZ 85062-2907

REF#1206042CS

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2. Once your current task is complete, take the next step – fill out all of these fields - MAILING ADDRESS NUMBER AND STREET, CITY, STATE, ZIP CODE, Permission is hereby granted to, Signature, Todays Date, NOTE Application must be signed by, GUIDELINES EFFECTIVE JULY For, Mail completed form to Arizona, and REFCS with their corresponding information. Make sure to double check that everything has been entered correctly before continuing!

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