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2. Utility Rate Payback Program Application Overview

   On August 18, 2022 the City Council approved the City’s American Rescue Plan Act (ARPA) Expenditure Plan which included $1,000,000 in direct residential assistance by way of a Utility Rate Payback Program.   Because the City provides no utility services, we are partnering with Jurupa Community Services District and Rubidoux Community Services District for this program.  Residents of Jurupa Valley receiving water service from either of these agencies will receive an automatic rebate on their water bill.  For those residents mainly living in apartments or mobile home communities that do not receive water bills from the utility agencies, an online application will be available on the City’s webpage.

4. Language Translation
   This form is available in English, Spanish, and over fifty (50) other languages. Use the Google Translate tool located on the bottom right of the screen to select your language preference.
6. Traducción de Idiomas
   Este formulario está disponible en inglés, español y en más de cincuenta (50) idiomas. Use la herramienta ‘Google Translate’ ubicada abajo a la derecha de la pantalla para seleccionar su idioma preferido.
8. Link to LEAP Web Page
   Jurupa Valley LEAP Web Page
12. Applications Process for Residents

    You may qualify for a Utility Rebate, please continue with the application by answering the questions below

14. Do you currently receive a water bill from either RUbidoux Community Services District or Jurupa Community Services District?*

    1. No
    2. Yes
16. Are you a resident of Jurupa Valley?

    1. No
    2. Yes
18. Has COVID-19 negatively impacted your ability to pay your utility bills?

    1. No
    2. Yes
20. Are you able to submit a utility bill with your name and current address on it?

    1. No
    2. Yes

    Utility bills must be current (within 6 weeks of submittal).

24. Section 1: Applicant Business Owner Information
26. (1.1) Full Name of Applicant*
28. (1.2) Home Address*

    Provide the full home address (Number, Street, City, State, and Zip). Address must be the same as the address of water bill. 

30. (1.3) Mailing Address

    If different from residence.

32. (1.4) Email Address*

    Provide email address.

34. Phone Number*
36. Apartment or Mobile Home Name
38. Upload current SCE or Gas Bill With Matching Address*

    Name and Address on bill must match applicants name and address. Bill must be current. Bills older than six weeks from the date of application will not be accepted.

42. Section 2: Acknowledgement & Authorization
44. (2.1) Authorization to Submit Application*

    By submitting this form, I certify that the above statements included in this application are true and correct to the best of my knowledge. I understand that a false statement may disqualify me from benefits.

    1. I authorize this application to be submitted
46. Full Name Authorization*
    Provide the full name of the person that is authorizing the submission of this form. This will serve as your electronic signature.
47. Date of Authorized Submittal*
    Date of Authorized Submittal

    Provide the date for the authorization/electronic signature.

Leave This Blank:


49. 1. Receive an email copy of this form.
50. Email address

    This field is not part of the form submission.

51. Submit

* indicates a required field