(Sample) UTILITY USER'S TAX EXEMPTION/ELECTRIC & WATER LIFELINE RATE APPLICATION
Jan 11, 2022
submission
#15
Submit application
Your information
| First Name | --- |
| Service Address | --- |
| Best contact phone number | --- |
| Copy of your Driver's license or ID Card (for Senior age verification) | --- |
| I am requesting Lifeline services because I am | Both |
| My annual income in the last year | --- |
LADWP Lifeline services
| Lifeline services requested | Electric |