CAP-Sewer Online Application

The Murphys Sanitary District (MSD) Customer Assistance Program (CAP-Sewer) provides limited financial assistance to qualifying low-income residential customers to help offset a portion of their sewer service costs. The program operates within the fiscal capacity of the District and is subject to annual funding approval by the MSD Board of Directors. Please complete and submit the application below.

Applicant Name (required)

Service Address (required)

Mailing Address (if different) (required)

Phone Number (required)

Email Address (required)

Account Number (required)

Number of People in Household (required)

Housing Status (required)

Program Eligibility (required)

My account is impacted by a rate increase.

My account is active and in good standing (not delinquent).

My residence type is a single-family residence with one connection. (mobile home parks, apartments, multifamily residence not eligible)

I reside full-time at the address listed above and receive sewer service from Murphys Sanitary District. Provide ONE of the following (attach documentation):

Provide ONE of the following (attach documentation)

Proof of enrollment in PGE CARE Program

Verification of household income at or below 200% of the federal poverty guidelines.

Rental Verification (if applicable)

Copy of current rental agreement showing property address, owner/tenant names, and signatures

If no written agreement, attach a CAP tenant authorization form signed by the legal property owner.

APPLICANT CERTIFICATION By signing below, I certify that: 1. The information provided on this application is true and correct. 2. I understand that providing false or misleading information may result in permanent removal from the program and repayment of any credits received. 3. I agree to notify Murphys Sanitary District immediately if my income status changes or if I no longer qualify for this program. 4. I understand that credits are applied only to active accounts in good standing and that I must reapply annually between April 1 and May 31 to remain eligible. 5. I acknowledge that participation in CAP-Sewer does not confer entitlement to continued assistance and is subject to available funding.

Applicant Signature (By typing your name you authorize the District to process your application) (required)

Date (required)

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