Section 1 of 1 in this document

Sewer, Stormwater, and Water Financial Assistance Application

The City of Portland offers sewer, stormwater, and water bill discount program for all eligible households receiving water and/or sanitary sewer service as a direct customer of the Portland Water Bureau or Bureau of Environmental Services.

Eligibility Requirements

Property must be a single-family home that receives sewer or water services from the City of Portland.

Applicant must live at the property and be directly responsible for the payment of the sewer/stormwater/water bill.

Applicants that have an ADU (Accessory Dwelling Unit) on their property with one water meter that serves both the primary home and the ADU, are not eligible to participate in the discount program.

Applicant must meet the established income guidelines by submitting proof of total gross income for all adult members of the household. Gross monthly household income for those 18 and older determines eligibility. Gross income means the amount of money before taxes or deductions.

If approved for the bill discount, you will receive the discount for up to 2 years and will begin with your next sewer, stormwater and water bill. This discount does not automatically renew. To continue, you will need to reapply after 2 years. It is your responsibility to notify us immediately if your income changes and you no longer qualify.

Income Eligibility (Valid until July 2024)

Household Size	Tier 1 - 60% of MFI (Monthly Income)	Tier 2 - 30% of MFI (Monthly Income)
1 person	Under $3,950	Under $1,975
2 person	Under $4,515	Under $2,258
3 person	Under $5,080	Under $2,540
4 person	Under $5,640	Under $2,820
5 person	Under $6,095	Under $3,048
6 person	Under $6,614	Under $3,307
7 person	Under $6,995	Under $3,498
8 person	Under $7,445	Under $3,723

For each additional person in Tier 1, add $450 to the monthly income.

For each additional person in Tier 2, add $225 to the monthly income.

If you have any questions, please contact Portland Water Bureau Customer Service at 503-823-7770 or email pwbcustomerservice@portlandoregon.gov

Application Information

Full Name (required)

Service Address (required)

Phone Number

Language Spoken

Account Number

Select application type (required):

New

Renewal

Household Information (including yourself)

Please note that date of birth should only be filled in for household members that are 60 or older.

Name of Household Member 1

Date of Birth Household Member 1

Social Security Number Household Member 1

Does household member 1 have income?

Name of Household Member 2

Date of Birth Household Member 2

Social Security Number Household Member 2

Does household member 2 have income?

Name of Household Member 3

Date of Birth Household Member 3

Social Security Number Household Member 3

Does household member 3 have income?

Name of Household Member 4

Date of Birth Household Member 4

Social Security Number Household Member 4

Does household member 4 have income?

Name of Household Member 5

Date of Birth Household Member 5

Social Security Number Household Member 5

Does household member 5 have income?

Name of Household Member 6

Date of Birth Household Member 6

Social Security Number Household Member 6

Does household member 6 have income?

Name of Household Member 7

Date of Birth Household Member 7

Social Security Number Household Member 7

Does household member 7 have income?

Name of Household Member 8

Date of Birth Household Member 8

Social Security Number Household Member 8

Does household member 8 have income?

If you have more people, attach additional information on a separate form.

Financial Information

Your application will not be processed if income documentation is not received.

Salaries, wages, and/or tips income amount

Self-employment income Salaries, wages, and/or tips income amount

Social Security, including AFDC and welfare income amount. Food stamps are exempt.

Pensions, annuities, interest, or dividends income amount

Alimony and/or child support income amount

Public assistance includes TANF, AFS verification or Medicare Card income amount

Unemployment benefits income amount

Veteran's benefits income amount

Rental property income amount

Amount of other types of income received

Total Gross Monthly Income of Household. (This amount is auto calculated based on all income amounts you've entered above.)

Please upload REQUIRED proof of income documents for the last 30 days. Up to 10 files can be uploaded not exceeding 250MB. All file types are accepted except for exe, dmg, sh, js, php, pl, pkg.

Please sign here. Full Name and Email are required fields.

First Name

Last Name

Choose how to sign

Draw Type

I certify that the information above is truthful and correct. I understand that if it is determined that the information provided is untruthful or false, the City will terminate the discount and may rebill me for the discount received. I agree to electronically sign and to create a legally binding contract between the other party and myself, or the entity I am authorized to represent.

FOR AGENCY USE ONLY

Date Approved by Agency

Agency Name

Agency Representative Name

The City of Portland is committed to providing meaningful access and reasonably provides translation, interpretation, modifications, accommodations, alternative formats, auxiliary aids, and services. Call 503-823-7770
Traducción e Interpretación | Biên Dịch và Thông Dịch | अनुवादन तथा व्याख्या | 口笔译服务 | Устный и письменный перевод | Turjumaad iyo Fasiraad | Письмовий і усний переклад | Traducere și interpretariat | Chiaku me Awewen Kapas
Translation and Interpretation: 503-823-7770 | Relay: 7-1-1 | www.portlandoregon.gov/water/access

Sewer, Stormwater, and Water Financial Assistance Application

Eligibility Requirements

Income Eligibility (Valid until July 2024)

Application Information

Select application type (required):

Household Information (including yourself)

Financial Information

Select all income sources that apply in your household, then enter the Gross Monthly amount for each corresponding income source selected. Numbers and decimal only; no comma. Gross income is the amount of money you make before taxes and any other deductions. REQUIRED to select at least one.

Total Gross Monthly Income of Household. (This amount is auto calculated based on all income amounts you've entered above.)

Please upload REQUIRED proof of income documents for the last 30 days. Up to 10 files can be uploaded not exceeding 250MB. All file types are accepted except for exe, dmg, sh, js, php, pl, pkg.

Please sign here. Full Name and Email are required fields.

FOR AGENCY USE ONLY