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CITY OF UNION CITY
UTILITY USERS TAX EXEMPTION APPLICATION
PG&E CARE PROGRAM
Contact Information
Last Name
*
First Name
*
M.I.
Street Address
*
Address Line 2
City
*
State
*
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Washington DC
Zip Code
*
Phone Number
*
Email Address
*
QUALIFICATIONS FOR TAX EXCEMPTION
Are you enrolled in Pacific Gas & Electric Company's (PG&E) CARE Program (California Alternate rates for Energy program)
Are you enrolled ?
Yes
No
If you answered no, please fill out the low income or senior excemption form(if applicable)
UTILITY INFORMATION
-
Does not apply to water , sewer, and garbage.
Utility 1
*
Account Number 1
*
Name on account 1
*
Utility 2
Account Number 2
Name on Account 2
Utility 3
Account Number 3
Name on Account 3
Utility 4
Account Number 4
Name on Account 4