- The water and sewer bill is in your name.
- You are a full time resident at the address where the discount will be received.
- You have only one water service account with the SFPUC.
- You are not claimed as a dependent on another person’s tax return.
- Your total combined household gross income must not exceed the CAP Income Guidelines
Income Guidelines Effective July 1, 2020 – June 30, 2021
The total combined income should be less than or equal to the amount shown in the table.
|Number of persons in household
|Total combined annual income
|1 or 2
||Add $8,960 for each additional household member
• Option 1: I currently receive CalWorks, CalFresh, or Medi-Cal benefits from San Francisco Human Services Agency (HSA) and give permission to HSA to share my income information.
By selecting this option, I give permission to HSA to share limited income information with SFPUC. My information shall be shared only as needed to determine whether I qualify for SFPUC’s Community Assistance Program. I understand that this database can only show my name, my address, and whether my household income falls within certain percentages of federal poverty guidelines based on information I have previously provided to HSA. This release of information expires one year from the date I sign on page 2 unless I cancel it in writing before then.
• OPTION 2: I will submit a signed copy of the most recent Federal Tax Return(s) for all income-earning members of my household.
Please submit all pages of your signed Tax Return. All household members without income should be listed as dependents on the Federal Tax Return of another household member; if not listed, submit required documents specified in Option 3.
• OPTION 3: I will submit income documentation and proof of occupancy for each member of my household because my Federal Tax Return is NOT available.
Income documentation may include: 2 consecutive paycheck stubs; 2 consecutive copies of Social Security or SSI checks; W-2 forms; Social Security benefit statement; unemployment benefits statement.
Proof of occupancy may include: recurring bills, bank statements, or other types of correspondence that include the name of the household member and the service address of the water bill. List which documents you are submitting for each household member on the table in Section D.
Each household member should submit his/her own individual income documentation as listed above, with their name and address printed on the form. Any dependents or other individuals in the household without income (i.e., children, elderly, non-working) should either appear as a dependent on the Federal Tax Return of another household member or should submit a copy of a recent recurring bill, bank statement, or other type of correspondence that includes the name of the household member and the service address of the water bill.
Household income is defined as the combined gross income of ALL persons who live in the household, whether taxable or non-taxable. Gross income includes, but is not limited to the total income from: Wages, salaries, pensions, unemployment benefits, disability payments or workers compensation, Gross Income from self-employment (IRS Form 1040 Schedule C), child or spousal support, worker's compensation, unemployment benefits, proceeds-sales price (IRS Form 1040 Schedule D), interest or dividends from savings accounts, stocks, bonds, retirement accounts, rent or royalty income, cash income or gifts, scholarships, grants, or other aid used for living expenses, insurance or legal settlements, Social Security, SSI, SSP, SSDI.
Complete, ensure all required signatures are included and date the application.
Review our Frequently Asked Questions page. You can request a CAP application by contacting Customer Services at (415) 551-3000.
Anyone receiving the CAP discount and found to be in violation of program rules will be removed from the program and may be liable for repayment of the discount from the time that the discount was received.
CAP applicants and re-enrollments are encouraged to participate in a free water conservation home evaluation. Our Water-Wise Evaluation program is facilitated by a trained water conservation specialist and can lower your bill even more! Each ‘site-specific’ visit will provide free showerheads and faucet aerators, if needed, help detect costly plumbing leaks and show you ways to conserve our great drinking water.
WATER-WISE EVALUATIONS ARE AVAILABLE FOR NEW AND EXISTING CAP CUSTOMERS UPON REQUEST. TO SCHEDULE THE EVALUATION, PLEASE CLICK HERE OR CALL (415) 551-4730.
Helping Families in Need Save Water and Money!