2023 Utility Assistance Application & Required Documents
This file contains the 2023 Utility Assistance Application along with a list of required documents and instructions for applicants. It explains the necessary steps to complete the application process. Additionally, it provides guidelines for proving citizenship, residency, and identity for all household members.
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How do I fill this out?
To fill out this application, start by gathering all required documents. Next, complete all pages of the application with accurate information. Finally, submit the application by mail or fax.

How to fill out the 2023 Utility Assistance Application & Required Documents?
1
Gather all required documents.
2
Complete Pages 1-5 of the application and answer all questions 1-17.
3
Submit proof of identity and citizenship for all household members.
4
Provide proof of current income for all household members over 18 years of age.
5
Submit the completed application along with all required documents by mail or fax.
Who needs the 2023 Utility Assistance Application & Required Documents?
1
Households needing financial assistance with utilities.
2
Household members who need to verify their citizenship or legal residency.
3
Individuals with limited income requiring proof of financial information.
4
Former military service members seeking additional benefits and services.
5
Residents of Houston, TX applying for utility assistance.
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What are the instructions for submitting this form?
Submit your completed application and required documents by mail or fax. Mail to BakerRipley - Utility Assistance, 3838 Aberdeen Way, Houston, TX 77025 or fax to (832) 295-5834. Ensure all documents are legible and include proof of identity, citizenship, and income.
What are the important dates for this form in 2024 and 2025?
Applicants should allow up to 8 weeks for determination of eligibility. Make sure to submit your application as soon as possible to avoid delays.

What is the purpose of this form?
The purpose of this form is to provide utility assistance to households in need. It ensures that applicants provide necessary documentation to verify their identity, citizenship, and income. This process helps BakerRipley determine eligibility and distribute financial assistance based on program requirements.

Tell me about this form and its components and fields line-by-line.

- 1. Pages 1-5: Answer all questions 1-17
- 2. Proof of Identity: Submit proof of identity for all household members.
- 3. Proof of Citizenship: Submit proof of citizenship for all household members.
- 4. Income: Proof of current income for all household members over 18 years old.
- 5. Electric Bill: Current utility bill or disconnect notice.
- 6. Gas Bill: Current bill or disconnect notice.
- 7. Water Bill: Current bill or disconnect notice.
- 8. SAVE Certification Form: Verify citizenship or legal residency status for all household members.
What happens if I fail to submit this form?
Failure to submit this form will result in delayed processing or denial of assistance.
- Incomplete Application: May cause delays in review and potential denial of the application.
- Missing Documents: Without required documents, eligibility cannot be determined.
- Delayed Assistance: Applicants may experience delays in receiving financial aid.
How do I know when to use this form?

- 1. Utility Financial Aid: Apply for assistance with electric, gas, or water bill payments.
- 2. Identity Verification: Provide proof of identity for all household members.
- 3. Income Verification: Confirm current income status of household members.
- 4. Citizenship Verification: Submit documents proving citizenship or legal residency.
- 5. Veterans Assistance: Former military members may use this form to apply for additional benefits.
Frequently Asked Questions
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Open the PDF in the PrintFriendly editor and use the editing tools to update the information. Save and download your edited document.
Can I sign the application digitally?
Yes, you can add your digital signature using the signature tool in the PrintFriendly editor.
What documents do I need to submit with the application?
You need to submit proof of identity, citizenship, and current income for all household members, along with the utility bills.
How do I share my completed application?
Use the share feature in the PrintFriendly editor to generate a shareable link or send the file via email.
What happens if my application is incomplete?
Incomplete applications will delay the review process and may result in denial of assistance.
How can I verify my citizenship status?
Provide a valid U.S. passport, tribal enrollment card, or other acceptable documents listed in the instructions.
Can I submit the application online?
Currently, applications can be submitted by mail or fax as indicated in the instructions.
What is the SAVE Certification Form?
The SAVE Certification Form is used to verify the citizenship or legal residency status of each household member.
How do I prove my income?
Submit proof of current income for all household members over 18 years old, such as pay stubs, pension statements, or Social Security award letters.
Where can I find assistance for former military service members?
Visit the Texas Veterans Portal at https://veterans.portal.texas.gov/ for additional benefits and services for former military service members.
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