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apply for support

Step 1

Review Rules for Eligibility

In order to apply for assistance from AccessH20, applicants must meet the following minimum criteria:

  • You must be referred to AccessH2O through your utility or qualified community partnership agency. Please contact your utility or [email protected] to see if they have a partnership agreement with us.
  • Demonstrate that the property is where you currently live full-time.  
  • Be a residential water customer. Commercial/Business customers are not eligible at this time.
  • Have the water/sewer bill in your name or evidence that you are responsible for paying the bill through a signed and valid rental agreement.  Tenants do qualify for assistance through AccessH2O.
  • Have a property with a dedicated water meter, meaning the meter and bill are only for your location.
  • Have made ‘good faith’ payments and communicated with your utility on the past due balance. AccessH2O requires a minimum of three monthly payments made directly by the customer (not through external agencies) in a rolling twelve-month period for monthly billed customers or the equivalent of one full quarterly payment for quarterly billed customers.  
  • Agree to allow AccessH2O to contact the utility on your behalf and request information regarding your account including, but not limited to, billing, payment, and communication history.
  • Have a financial hardship that you can share with AccessH2O in enough detail to allow us to determine eligibility.
  • Have not received assistance from AccessH2O in the past 24 months or been denied assistance.

“Our organization does not and shall not discriminate on the basis of race, color, religion (creed), gender, gender expression, age, national origin (ancestry), disability, marital status, sexual orientation, or military status, in any of its activities or operations."  



Paperwork that should be submitted with your application includes:

the organization that referred you to our services, copies of your recent water/sewer bills, proof of hardship, Proof of Payment History, and other correspondence or information that shows your eligibility.  

Please do not forget to sign and date your application if you mail it

Fill Out Online

This is the fastest method of submitting an application to AccessH2O.  

Fill out the online application, upload the necessary documents and submit it for review.  You will hear back from AccessH2O within 3 business days.  


Spanish Application





Print Form and Mail/ Email

From here you can fill out and print the application and either email or mail the signed application and supporting documents and information to:


885 Woodstock Rd.

Suite 430-312

Roswell, GA 30075

or send to [email protected]

Form to fill out online

and print and sign

Solicitud De Asistencia - Español

Imprimir y firmar

Fax Form

From this link you can download and print the application or pick up a printed copy at your utility and fax the completed application to: 404-860-1698.

Please do not forget to sign the application and include all supporting documents and information.

Form to Print Out and Mail / Fax

Step 3: Review Plan

AccessH2O is designed to be a solution for customers needing assistance to recover from temporary hardship or to catch-up from a past due balance.   AccessH2O is not a good option if you cannot pay your average monthly bill or have an ongoing leak.  Several factors are considered when prioritizing aid, and AccessH2O eligibility is not a guarantee for support.  

In order to be approved for aid, you must understand and agree to the following terms:

  • AccessH2O does not provide aid directly to customers.  
  • Any approved payments are made directly to the utility (or other provider ) on behalf of the customer.  
  • AccessH2O does not take responsibility for the applicant's water or sewer bill.  The customer always maintains responsibility for the amount due.
  • If approved, AccessH2O will work with your utility to set-up a payment arrangement or plan that will divide your past due amount into separate installments. You must agree to pay future bills (minus the installment amount) prior to the due date and notify AccessH2O once each new bill is paid. AccessH2O will then make a payment towards the past due installment.  
  • AccessH2O's support will not exceed $1200 per customer.  
  • While the installment is active, you will not incur late charges or be subject to shut-off on that account. If you fail to pay the current bill on time, if any of the payments are returned for insufficient funds, or if there is evidence of improper account activity (theft of service, etc.), the agreement is considered void and no further payments will be made on your behalf.  Account activity is subject to review or audit without notice.
  • This agreement does not form a contractual obligation.