Financial Hardship Statement
Two Ways to Apply
To submit your application, simply tap APPLY NOW. Please be sure to have all required documents ready for upload. If you wish to fax or mail your application, tap DOWNLOAD and complete the application form. Please note, this option will greatly delay processing time. Application also available in Español.
Financial Hardship Agreement Instructions
If you're experiencing a severe financial hardship and cannot pay your past due balance, you may qualify for a financial hardship agreement. This will not lower your bills, but allow you to pay off the existing, past due balance in monthly installments, in addition to your regular bills in the future. We will use this application to document your paid expenses vs. your income and determine your ability to make payments. Once we receive and review all of the required documents, a representative will contact you to discuss the terms of the payment agreement.
Please note this financial hardship agreement is a one-time offer for the life of the account and should only be utilized during extreme circumstances.
To see if you qualify for a bill discount, view our Household Assistance Program. For energy efficiency tips that can help you save energy and money, visit here.
Proof of Income Need for Application
Proof of income includes all household income within the last 30 days for everyone, 18 years of age or older, living in the same household. If there is no household income within the last 30 days, you may still qualify. Assistance from your Department of Social Services may be available as well. Proof of income accepted is listed below. We will also consider notarized statements from employer or notarized letters from parent, tenant, etc.. Notarized letters should include date received and dollar amount.
Net Income
- Pay Stubs (last 30 days)
- Bank statement showing direct deposit/proof of paid bills etc.
- Food stamps award letter
Expenses
Proof of PAID expenses within the past 30 days Only PAID bills will be accepted:
- Mortgage/Rent receipt
- Heating oil
- Gas
- Electric
- Propane
- Car/Mass transit expenses (car loan, insurance, gasoline, metro card, LIRR)
- Water
- Sewer
- Insurance (homeowners, car or life insurance)
- Medical Expenses (co-pays, insurance, prescriptions)
- Child care
- Education/tuition
- Child support
- DSS payback
- Loans
- Court ordered payment
We will not accept:
- Unpaid bills
- Proof of income or expenses older than 30 days
- Phone or cable bill (allowance already provided)
- Food/Grocery bills (allowance already provided)