City of Delaware
Utility Assistance Program
Hardship Application
Resolution 20-31 authorizes the City of Delaware to establish payment plans and/or apply credits to utility bills
for unemployed customers and those financially impacted as a direct result of the COVID-19 pandemic. Please
complete this hardship application for each month that a credit or payment plan is requested. For assistance in
completing this form, please contact the Utility Billing Department via telephone at 740-203-1250 extension 4 or
through email at
Completed applications can be submitted via email at or placed in the red drop box
located in the southeast corner drive through at Delaware City Hall. Lastly please include any pertinent
documentation (layoff notice, state unemployment claim, communication from employer or customer of job loss)
to support an economic hardship when submitting this application, especially if a credit is being requested.
Customer Name
Account #
Service Address
Email Address
Billing Date
Amount Billed
Payment Plan
Yes No
Payment Plan Terms (Amount to Pay Per Month):
Credit Requested $
Explanation of