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Utility Billing Affidavit for Indigence


  1. 1. Introduction and Program Requirements
  2. 2. Customer Information
  3. 3. Household Information
  4. 4. Acceptance
  • Introduction and Program Requirements

    1. About the Program

      Residential customers who meet certain qualifications and are deemed to be indigent (suffering from extreme poverty) may complete an Affidavit for Indigence.

    2. Program Requirements

      The customer is financially unable to pay their City of Modesto utility bill within the normal billing cycle by demonstrating they or a member of their household is a current recipient of one of the following assistance programs: CalWorks, CalFresh, General Assistance, Medi-Cal, Supplemental Security Income (SSI), State Supplementary Payments (SSP), California Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). The customer demonstrates their household income is less than 200% of the federal poverty level.