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Utility Assistance Inquiry
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* Indicates required question
Email
*
Your email
First and Last Name
*
Your answer
Address
*
Your answer
Phone Number
*
Your answer
Are you currently employed?
*
Yes
No
Are you an Otsego County resident?
*
Yes
No
Are you the account holder on your utility request?
*
Yes
No
Utility assistance needed
*
Electric
Propane
Both
Other:
If other, what is your primary source of heat?
Your answer
Do you have a shut off notice?
Yes
No
Clear selection
What percent (%) is your propane at currently?
Your answer
If yes, how many months and total amount is past due?
Your answer
Do you have an eviction notice?
*
Yes
No
Have you received any utility assistance since October 1st, 2023?
*
Yes
No
If yes, what assistance did you receive and from what organization?
Your answer
Have you applied with Department of Health and Human Services (DHHS) for a State of Emergency Relief (SER)
*
Yes
No
If yes, do you have a determination of assistance?
Yes
No
Clear selection
How many individuals are in your household?
(Children and adults)
*
Your answer
Send me a copy of my responses.
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