• COVID-19 Municipal Utility Relief Program

    Utility Arrearage Assistance Customer Intake Form
  • CARES Act assistance application may provide assistance for bills dated March 1, 2020 to the present, and may not be used for past due amounts prior to this time period.

    Funding is designed to be a one-time opportunity, with only one payment per household (for residential) or account holder and their successors (for non-residential).

    Funding can be used for water and/or wastewater bills.

    • Limited funds are on a first-come-first-served basis.
    • Details of the program may change as new guidelines are received from the State.
    • ONLY active Chesapeake Public Utilities customers need apply.
    • If you don't have access to a computer call 382-6352.

  • General Information

    All applicants fill out this section.
  • Residential Customer Information

    Only Residential Applicants fill in this section, i.e. single family dwellings, parsonages, multi-family dwellings, etc.
  • Non-Residential Customer Information

    Only Non-Residential Applicants fill in this section, i.e. business locations, business owners, religious facilities, etc.
  • If your utility fee arrearage is  NOT due to economic hardship experienced as a result of the COVID-19 pandemic, you are  NOT eligible for CARES Act assistance. If you have any questions, contact the Chesapeake Public Utilities Department at  water@cityofchesapeake.net  or 757-382-6352.
  • Applicant’s Certification

    Signature and Terms for both residential and nonresidential customers.
  • By signing this form, I confirm:

    • I desire to receive any assistance to which I am legally entitled under this program and its specifications.
    • I certify that the reason I am eligible for this CARES Act assistance is correct to the best of my knowledge and belief.
    • I understand that my signature on this form gives permission for the staff at the CITY OF CHESAPEAKE to verify records as necessary to verify my eligibility for assistance.
    • I declare to the best of my knowledge that:
      1. for residential applicants: I am the only person living in the household at the address shown on this form who has applied for this assistance, or
      2. for non-residential applicants: I am the only person who has applied for/on behalf of the non-residential account holder, including their successors, at the address shown on this form and that I am not a government account holder.
    • I certify that this customer has not received CARES act relief for any of the arrearages I am applying for from any other source including Rebuild VA Grants.
    • I understand that if I give false information or withhold information in order to make myself eligible for benefits that I am not entitled to or apply for assistance at more than one site, I can be prosecuted for fraud and/or denied assistance in the future.
    • I understand that the agencies involved in this program may verify all of the information which I have provided.
    • I understand and my signature on this form gives permission to CITY OF CHESAPEAKE to which I am applying to verify information concerning my need for assistance.
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  • If you have any questions or concerns, contact the Public Utilities Department:
    water@cityofchesapeake.net
    757-382-6352

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