Welcome to the Utility Assistance Program Eligibility Form!

• SoCal Edison and SoCal Gas offer a utility assistance program for eligible households. Funds are limited per program period and distributed on a first-come first-serve basis.

• Eligible households may receive up to $200 towards an exising SoCal Edison bill and up to $400 towards an exisiting SoCal Gas bill while funds are available.

• For energy assistance, eligible households may receive assistance once per 12 months.

• For gas assistance, eligible households may receive assistance once per program period.

*Note: Our gas assistance program period is closed for this program period, but will be opening up in the next few months.

Which of the following utility assistance programs would you like to apply for? *

Energy Assistance Fund (EAF)

Gas Assistance Fund (GAF)

Both EAF & GAF

Is SoCal Edison your electric utility provider? *

Yes

Is SoCal Gas your gas utility provider? *

Yes

Client Eligibility Information

• In order to determine eligibility we require information on your household size and total household income for all members over the age of 18.

• If eligible, we will ask you to provide income documentation to attach with your UAP application.

First Name *

Last Name *

Please provide us with the number of members residing in your household (including yourself) : *

How many household members are over the age of 18 (including yourself)? *

How many household members over the age of 18 have an income (including yourself)? *

Please provide us with your total household monthly income (include all income for anyone 18+ residing in your household in the total) : *

How Can We Contact You?

Phone Number *

Email Address *

Which method of communication do you prefer? *