Forms and Information

Forms

Assistance Applications

• Discounted Rate Application – English (PDF)
• Warm Neighbor Application – English (PDF)

Service Agreements

• Landlord Agreement (PDF)
• PrePaid Program Agreement – English (PDF)
• PrePaid Program Agreement – Chuukese (PDF)
• PrePaid Program Agreement – Spanish (PDF)
• Residential Service Agreement – English (PDF)
• Residential Service Agreement – Chuukese (PDF)
• Residential Service Agreement – Spanish (PDF)

Other

• AutoPay Authorization Form – English (PDF)
• AutoPay Authorization Form – Chuukese (PDF)
• AutoPay Authorization Form – Spanish (PDF)
• Claim for Damages Form (PDF)
• Life Support Equipment Form – English (PDF)
• Life Support Equipment Form – Chuukese (PDF)
• Life Support Equipment Form – Spanish (PDF)
• Remote Meter Opt-Out Form – English (PDF)
• Remote Meter Opt-Out Form – Chuukese (PDF)
• Remote Meter Opt-Out Form – Spanish (PDF)

Links

• Federal Poverty Level Guidelines
• SmartHub – How to register (web)
• SmartHub – How to register (mobile)