Aps E 3 Form PDF Details

In order to properly file your taxes, you need to know what forms are required. The Aps E 3 Form is one such form and it is used specifically for self-employed individuals. Knowing which form to use and how to complete it is essential in ensuring that your taxes are filed correctly. This article will provide an overview of the Aps E 3 Form and explain how to complete it. If you are self-employed, you will need to file the Aps E 3 Form with your taxes. This form is used specifically for self-employed individuals and provides information about your income and expenses. Completing this form correctly is essential in ensuring that your taxes are filed correctly. In this article, we will provide an overview of the

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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This form will require specific info to be typed in, therefore ensure you take your time to enter what is required:

1. The aps energy supprt needs particular details to be typed in. Ensure the subsequent blanks are finalized:

Stage number 1 of completing aps energy support program form

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!

NOTE Application must be signed by, MAILING ADDRESS NUMBER AND STREET, and REFCS in aps energy support program form

It's very easy to make an error while filling out your NOTE Application must be signed by, and so be sure you go through it again before you decide to submit it.

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