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Low-Income Senior Citizen/Low-Income Disabled Citizen Reduced Rate Program

  1. Low-Income Senior Citizen/Low-Income Disabled Citizen Reduced Rate Program Application
    Applicants must meet the following qualifications and certify that:
  2. 1) I am over the age of 61; AND
    Please provide a copy of your government-issued ID, such as a driver’s license or identification card.
  3. 2) I have a total annual gross income not exceeding $55,743 annually, including that of a spouse or any co-occupants(s); AND
    Please provide a copy of your most recent income tax return.; AND
  4. 3) I already receive the property tax deferral/exemption for this property through Snohomish County.; AND
  5. 4) I own and reside in the residence noted below.
  6. -OR-
  7. 1) I am permanently disabled at the time of this application; AND
    Please provide proof of disability, in the form of a payment statement for SSI or SSDI.
  8. 2) I have a total annual gross income not exceeding $55,743 annually, including that of a spouse or any co-occupant(s); AND
    Please provide a copy of your most recent income tax return.
  9. 3) I already receive the property tax deferral/exemption for this property through Snohomish County.; AND
  10. 4) I own and reside in the residence noted below.
  11. I agree to notify the District should I move from this property, or if my gross annual income exceeds the amount above. I further agree to provide the District with financial information to support my application, and agree to provide future income information if requested by the District to verify my eligibility. I acknowledge that information provided by me in support of my application is a public record and subject to public disclosure. I agree to waive any claim of confidentiality in any information provided and I agree to release Mukilteo Water & Wastewater District, and its employees, agents, officers, and Commissioners from any liability or claims, which might arise from the disclosure of such information to any other party or entity. I certify, under penalty of perjury, under the laws of the State of Washington, that the foregoing is true and correct.
  12. Electronic Signature Agreement
    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.
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