FORMS

Application for Reduced Water/Sewer Base Fee
Senior and/or Disabled Citizen

DOUGLASVILLE-DOUGLAS COUNTY WATER AND SEWER AUTHORITY

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Overview of Reduced Water/Sewer Base Fee – Senior and/or Disabled Citizen:

The courtesy reduced water/sewer base fee set by the Douglasville – Douglas County Water and Sewer Authority (the “Authority”) is a fixed reduction available to qualifying residential customers who meet the requirements in this document and in the Authority’s Rules and Regulations.

Eligibility Requirements for Reduced Water/Sewer Base Fee Senior and/or Disabled Citizen

To be considered for a reduced water/sewer base fee, all the following requirements must be met:
  1. The utility billing must be for a residential dwelling served by a 5/8-inch or a 3/4-inch water meter; and
  2. The applicant responsible for paying the bill uses the service location as his or her permanent residence; and
  3. The gross household income of all individuals residing at the service location is less than the “very low” income limit for the Atlanta Metro Area as established annually by the U.S. Department of Housing and Urban Development (“HUD”), for the applicable household size, as referenced in the Authority’s Rules and Regulations and available for review at https://www.huduser.gov/portal/datasets/il.html (HUD income limits website); and
  4. The applicant must submit a completed Application for Reduced Water/Sewer Base Fee – Senior and/or Disabled Citizen and the accompanying Affidavit in a form acceptable to the Authority, in-person or with a person designated by the Authority; and
  5. The applicant must qualify under at least one of the following categories:

(a) Senior Citizen. At least one individual responsible for paying the bill and residing at the service location is sixty-five (65) years of age or older; and/or
(b)Disabled Citizen. At least one individual responsible for paying the bill and residing at the service location is handicapped as defined by Chapter 3 of Title 30 of the Official Code of Georgia Annotated.

Once the applicant has filed the required Affidavit and the water/sewer base fee reduction has been granted by the Authority, annual reapplication or renewal of the Affidavit is not required. However, it remains the duty of the applicant to notify the Authority immediately if circumstances occur which render the applicant ineligible for the water/sewer base fee reduction, including but not limited to: (a) moving from and/or no longer occupying the service location as his/her residence, even if the applicant still retains ownership of the same, or (b) an increase in the gross household income above the applicable HUD Income Limit, which is updated annually. In consideration of receiving the courtesy base fee reduction, the applicant shall provide updated information and submit a new Affidavit upon request by the Authority.  Continuation of the courtesy base fee reduction is contingent upon cooperation with Authority requests for updated information in connection with this Application.

Required Affidavit

Before submitting your application, please download the affidavit, complete and sign it, then upload the completed affidavit using the upload field below.

📄 Download Affidavit (PDF)

Required: Your application cannot be processed without the completed affidavit.

APPLICATION FOR REDUCED WATER/SEWER BASE FEE – SENIOR AND/OR DISABLED CITIZEN​

Applicant Personal Details

Name
Service Address

Application for Reduced Water/Sewer Base Fee - Senior and/or Disabled Citizen:

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Before submitting your application, please download the affidavit, complete and sign it, then upload the completed affidavit using the upload field below. Please note: Your application cannot be processed without the completed affidavit.
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