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 your application, a representative will contact you to advise of any necessary documentation and discuss the terms of the payment agreement if approved.

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.

Application Requirements
On this application, you will fill out your income and paid expenses from 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. Sources of income and allowable expenses are listed below.

Net Income

• Pay Stubs (last 30 days)
• Any other source of income over the last 30 days
• Food stamps award letter

• Mortgage/Rent receipt
• Heating oil
• Gas
• Electric
• Propane
• Car/Mass transit expenses (car loan, insurance, gasoline, OMNY, 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
• Income or expenses older than 30 days
• Phone or cable bill (allowance already provided)
• Food/Grocery bills (allowance already provided)