apply for support
Review Rules for Eligibility
In order to apply for assistance from AccessH20, applicants must meet the following minimum criteria:
“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 - your application cannot be processed without a signature.
Fill Out Online
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.
Roswell, GA 30075
or send to [email protected]
Form to Fill Out Online and
Print and Sign
Solicitud De Asistencia - Español
Imprimir y firmar
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
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: