Apply for assistance

Welcome to The Human Utility assistance program. We look forward to helping you with your water bill. Please fill out the following information so we can confirm your eligibility.

If you’d like more information about how this program works, you can read about it here.

  Confirmation

By applying for assistance, I certify I am being truthful about my ability to pay my bill. I will provide proof to confirm information on this application. I understand this program does not a guarantee immediate assistance. I will receive a decision within ten (10) business days. I also understand my information may be shared with the utility for verification purposes.


  General information

All required fields are marked with *

If renting, do not use your landlord's name here.

We determine your city from your ZIP code.

We need this to be able to talk to the water company for you about your account.

  Contact information

Choose how you would like to be contacted about the status of your application (choose as many as you would like):

We need your phone number in case we need to ask you questions. We will only text or call you if you choose those contact options.

We need your email address to stay in touch with you and in case we need to ask you questions. If you don't have an email address, leave this blank.

  More information about your situation

Please double-check. An incorrect number delays your assistance.

This must be a number. For example, 3. Feel free to include additional details at the bottom of this page. Do not include adults only there on weekends or temporarily.

This must be a number. For example, 3.

Include things here such as more details about your employment status, shut-off dates, etc. The more we know, the more likely your application will be approved and the more quickly we can help.