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Dear Citizen: We are excited to announce that City Council passed Ordinance 1862 to revamp Low Income Affordable Municipal Service Rates. Applicants who qualify will receive $37.58 credited towards their Municipal Services bill each billing cycle. ELIGIBILITY REQUIREMENTS: The applicant must own the property where Municipal Services are being billed The applicant must reside at the address for at least nine months per year. The billing location must be owned by a municipal services customer with a total gross household income that does not exceed Wyoming Low Income Energy Assistance Program (LIEAP) guidelines for the total household size, which equals sixty percent of the state median income based on the household size and including gross income of all household members. The applicant must not have any delinquent amount associated with the Municipal Services bill. The applicant agrees to immediately notify the Municipal Services Department of any changes in status which may affect their eligibility under Ordinance 1862. The applicant must re-apply for the program on an annual basis. The deadline for reapplication every year is June 1st. If you meet these qualifications, please complete the following application, and provide the City of Laramie with copies of the necessary documents that show current enrollment in a federal program with low income as a necessary qualification. If you have any questions, please call the Municipal Services Billing Department at 721-5222. Sincerely, Municipal Services Billing Department City of Laramie CITY OF LARAMIE Administrative Services Department PO BOX C Laramie, Wyoming 82073 PHONE: (307) 721-5222 PHONE: (307) 721-5324 FAX: (307) 721-5211 ---PAGE BREAK--- FREQUENTLY ASKED QUESTIONS ABOUT COL ORDINANCE 1862 1. HOW DO I QUALIFY FOR LOW INCOME AFFORDABLE MUNICIPAL RATES? If you meet the eligibility requirements, please complete the application, and bring it in, along with a copy of the paperwork to demonstrate your current enrollment in a federal program in which low income is a necessary qualification. 2. HOW DO I KNOW IF I QUALIFY? After reviewing your submitted documents, the City will send you a notice in the mail advising you or your qualification status. 3. WHEN WILL THE LOW-INCOME CREDIT FIRST APPEAR ON MY BILL? After approval, the credit established by this ordinance will begin on the first day of the billing period after the application is approved and processed by the City. 4. DO I NEED TO RENEW MY APPLICATION AND HOW OFTEN? Yes, each application must be resubmitted annually for review by June 1st. 5. WHAT HAPPENS IF I NO LONGER QUALIFY? Households receiving the credit pursuant to the ordinance shall report to the City of Laramie any change in circumstance which may affect their eligibility for additional review of their account. CITY OF LARAMIE Administrative Services Department PO BOX C Laramie, Wyoming 82073 ---PAGE BREAK--- Please check one: New Application Annual Renewal DATE OF APPLICATION: NAME: ADDRESS: PHONE NUMBER: BIRTH DATE: NAME/BIRTH DATE OF OTHER PERSONS RESIDING IN HOUSEHOLD & RELATIONSHIP: Name/Date of Birth Relationship to Applicant Are you the owner at the above address? Do you Reside at this address for at least nine months a year? I certify that the above information and attachments provided by me are true and correct to the best of my knowledge, and I understand that willful misrepresentation will result in loss of credit eligibility. Signature of Applicant Date For Official Use Only Income Verified? Tax Return Other: Status: Approved Denied CITY OF LARAMIE Administrative Services Department PO BOX C Laramie, Wyoming 82073 APPLICATION FOR LOW INCOME AFFORDABLE MUNICIPAL SERVICES RATE