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If you have questions, call us at (215) 685-6300

City of Philadelphia
Water Bill:

Customer Assistance Program Application

EN / ES

This is the customer assistance application to help Philadelphians who are having trouble paying their water bills.

If you’re struggling to pay your water bill, this application is for you.

Ways to Apply

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Receive in the Mail

Fill out the first part of the application online or you may call (215) 685-6300 to request an application be mailed to you.

You have 14 days from when you request the application to when you must return it. You will also need to make photocopies of documents to send back with the application.

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Complete Online

When applying online, you won’t be able to save your progress, so you’ll need to be prepared to complete the application all at once. The application takes most people about an hour to complete.

Be sure you have every document you’ll need and access to a scanner or a camera (like the one on your phone) so you can submit your documents electronically.

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Print, Complete and Send

Print an application from home and mail it once completed. You have 14 days from when you request the application to when you must return it.

You will need the following to apply

Do not send originals.

Information for everyone in your household

  • Water Access Code (found on your bill)

    ?

    example of water bill
  • Names
  • Date of birth
  • Monthly income amounts
  • Social security numbers (for anyone 18-65 years old)

Proof of residency - It must be dated within the past six months. You need one of the following.

  • Current government issued ID with current address (such as driver’s license or ID card)
  • Current rental agreement, or agreement for sale for the dwelling unit
  • Recent utility bill, tax bill, or other tax record. You only need to include the first summary page showing your name and address.
  • Lease, rent book, or money order receipts that show your address

We understand gathering this information can be difficult. If you’re having problems, or have questions about the process, call (215) 685-6300.

Income documentation - You need one for each source of income for your household.

  • Prior year’s federal income tax return
  • Pay stubs
  • Benefit award letters for unemployment, worker’s compensation, social security, pension, or welfare benefits
  • Income support statement form from whomever is providing support to your household

If you are reporting zero income, you will be asked about other assets you may have, like a home, a car, savings, or securities.

Hardship documentation - If you’re applying for special hardship assistance because you have had an increase in household size, job loss, serious illness, death of the household’s primary wage earner, or you have been a victim of domestic violence, you need one of the following:

  • Birth or adoption certificate
  • Employment termination letter
  • Unemployment compensation printout
  • Hospital admission or discharge documentation
  • Death certificate
  • Safe harbor program documentation
  • Monthly expense statements
  • Proof of a recent hardship claim approval by a state or local agency

We understand gathering this information can be difficult. If you’re having problems, or have questions about the process, call (215) 685-6300.

Continue to Form

If you need further help:

You can visit a Water Revenue Bureau office or Neighborhood Energy Center for help getting an application or questions about completing one. Make photocopies of all your paperwork and place in a folder. Do not send original documents.

If you can’t make copies, or print an application, the Neighborhood Energy Centers may be able to help you.