Customer Assistance Program (CAP) Application

Thank you for applying to the Customer Assistance Program.

 Please note prior to completing an application:

  • Prior to starting the CAP online application, please review the requirements by clicking on this link to ensure the application is correctly completed.
  • After reviewing the online CAP Application form, please have the necessary document information readily available.
  • Use a PC or Mac with Chrome browser or Android devices. iOS devices cannot be used to create and upload a file.
  • Only one file per application is allowed (PDF or MS Word document).
  • Files from PC, Macs or Android using Chrome browser are allowed.
  • To successfully complete the application process, you must complete steps one through four, upload one file of all financial support documents, and click Submit in Step 4.
  • Once your application is submitted, you will receive a confirmation email. The email will not provide a copy of your application. Please keep a copy of your submitted documents for your records.
  • Please allow 30 days for processing. You will receive a response in the U.S. mail regarding your CAP application status.

If you have questions, please email customerservice@ebmud.com or call 866-403-2683. Customer Service hours: 8 a.m. to 4:30 p.m., Monday through Friday.

Step 1 of 4 - Customer Information

Step 2 of 4 - Household and Income Information

Household Income Information
You must report all income sources for each person who resides in this household. Check all income sources below that household members receive and attach documentation for each income source.
Household Income Sources *

Step 3 of 4 - Declaration and Application Checklist

Declaration and Application Checklist (Please read, check the three boxes to acknowledge the terms) *
Survey
How did you hear about EBMUD's Customer Assistance Program?

Step 4 of 4 - Upload Support Document and Submit Application

 
 Upload Instructions
  • Please combine all support documents into a single file. Do not upload multiple files. If you do, only the last file will be attached to your application.
  • File should be either in PDF or Microsoft Word
  • File name should use the following format:
    CAP-FirstName-LastName-MM-DD-YYYY.pdf
  • To upload file, click on Select File button and select the file from your device. Your file will upload immediately.
Select File
:
Cancel
To review your application, click Previous button. Otherwise, click the Submit button to submit application.