Show/Hide

City Hall will be closed on Thursday, 11/28 & Friday, 11/29 for Thanksgiving. Click here for all City Hall hours and closures. 

Utility Assistance Program Application

Print
Press Enter to show all options, press Tab go to next option
Please correct the field(s) marked in red below:

To enroll, complete this application form and include the following:

  • A scanned copy/photo of your Southern California Electric bill or Southern California Gas bill showing that you are enrolled in their CARE program
  • A scanned copy/photo of your City of Thousand Oaks utility bill
1
Customer Information
Customer Information
2

Agreement

I hereby authorize City of Thousand Oaks to enroll me in the Utility Assistance Program.

I agree to inform the City of Thousand Oaks if I become ineligible for the program.

I agree to furnish proof of eligibility when requested.

I understand that if I receive the credit without qualifying for it, I may be required to pay back the credits I received.

By typing my name below, I acknowledge this agreement.

 *
3

Upload required documents here:

Upload required documents here:
  1. To receive a copy of your submission, please fill out your email address below and submit.