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Utility Assistance Program

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WOOD VILLAGE UTILITY ASSISTANCE

ONLY ELIGIBLE FOR WATER & SEWER *

If you are a Wood Village community member and need assistance with your water and sewer bill, please submit the form below for consideration for Utility Assistance. If you are unable to complete this application online, use the “UA Application” button below to fill out or download the application. Completed applications can be emailed to city@woodvillageor.gov or dropped off at City Hall.

If you are having issues filling out the form below or with the application, please call City Hall at (503) 667-6211 to schedule an appointment with City staff to complete a paper application.

Wood Village community members may only apply once every six months for the Utility Assistance Program. Funded and supported by the City of Wood Village and ARPA funds.

UA Application

* If you need assistance with other utilities, like electricity, gas, or internet, please contact 211info.org 

*Completing this application is not a guarantee of utility assistance. Payment is based on funds available. A copy of the utility bill(s) for which payment is requested is required at the time of application. 

Utility Assistance Form 2023

"*" indicates required fields

Preferred Contact Method / Método de Contacto Preferido:*
Do you need a translator/interpreter? / Antes del evento, nos comunicaremos con usted para confirmar su recogida. ¿Necesita un traductor / intérprete?*
Does your household participate in any of the following programs? (Check all that apply) / ¿Participa su hogar en alguno de los siguientes programas? (Marque todo lo que corresponda)*

Financial Information for All Members of This Household

Income Per Month. Enter Gross Amounts.
Please attach a copy of the utility bill(s) for which you are asking for assistance. / Adjunte una copia de las facturas de servicios públicos para las que solicita asistencia.
Drop files here or
Max. file size: 50 MB.
    By entering your full name in the box below, you attest that all information provided is true to the best of your knowledge (*Completing this application is not a guarantee of utility assistance. Payment is based on funds available.):

    For City of Wood Village Use Only / Para uso exclusivo de la ciudad de Wood Village

    Do Not Complete This Section / No complete esta sección
    Signature
    MM slash DD slash YYYY
    This field is for validation purposes and should be left unchanged.