Page 19 - Desert Oracle September 2019

Community Action Program

Utility Assistance Requirements

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Utility assistance at the Surprise Care & Share Expo is available for Surprise and El Mirage residents
only. If you are interested in applying, please come prepared with the following required documents:

 For Applicant Only: U.S birth certificate OR U.S. passport OR proof of current legal resident
status. The applicant must be a member of the household for which they are completing the
application.

 For Applicant Only: Photo Identification

 Social security cards or official verification of social security numbers for ALL household
members

 Verification of ALL income received for the most recent 30 days by any household member.
For example: Social Security award letter, paystubs, verification of unemployment insurance
benefits, pensions, child support checks, DES cash assistance award letter, etc.

Your household income for the last 30 days, must be within the State Median Income Guidelines
(see chart below)

 Current or most recent utility bill for electric and gas. Please bring the entire statement or bill that
shows a full month’s billing cycle or service for the most recent month.

All of the above documents are REQUIRED to allow us to take an application for utility assistance.
Without these documents an application will not be taken. It is VERY important that you come
prepared to submit all your documentation.

STATE MEDIAN INCOME GUIDELINES
Find the size of your household in the top row. If household total gross income for the 30 day period
is at or below the amount in the second row, your household may be income eligible for assistance.

Household 1 2 3 4 5 6 7 8 9 10
Size

30 days
income $1,959 $2,562 $3,165 $3,768 $4,371 $4,974 $5,087 $5,428 $5,981 $6,533

If you have any questions or would like more information, please call the main line at
623.222.1600