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CARE Application and Renewal for
Sub-metered Tenants of Mobile Home Parks
and Apartment Complexes Only
Applicant Information
?
* Indicates required field
Please enter your 10 digit facility ID
*
If you do not know your facility ID,
call 1-800-427-2200.
Total Number of Persons in Household
*
Include yourself, other adults and children in the household
First Name
*
As it appears on your bill
Last Name
*
As it appears on your bill
Address
*
Apartment / Unit
*
Email Address
Home Phone
Retype Email Address
Cell Phone
CARE Participation
?
Please select one of the following:
I no longer qualify or wish to participate in CARE
-
You have requested to be removed from this program. Your account will be removed from the CARE Program and you will no longer receive the 20% discount.
I qualify based on Public Assistance Programs
If you or someone in your household receive benefits from any of the following programs,
please check the box(es) for all that apply.
Medi-Cal: Under Age 65
Medi-Cal: 65 or older
CalFresh (Food Stamps)
Medi-Cal for Families A & B
Women, Infants, and Children Program (WIC)
CalWORKs (TANF) or Tribal TANF
Low Income Home Energy Assistance Program (LIHEAP)
Supplemental Security Income
National School Lunch Program (NSLP)
Bureau of Indian Affairs General Assistance
Head Start Income Eligible - Tribal Only
I qualify based on my Household Income
Please check the box(es) for all sources of income in your household and provide your total household income below:
Source(s) of Income
Social Security
Pensions
SSP or SSDI
Interest or Dividends from: Savings, Stocks, Bonds, or Retirement Accounts
Wages and/or Salary
Unemployment Benefits
Disability or Workers Compensation Payments
Scholarships, grants, or other aid used for living expenses
Insurance or Legal Settlements
Spousal or Child Support
Cash, Other Income, or Profit from Self-Employment
Rental or Royalty Income
Please indicate your household's income range per year before deductions.
$0 – $39,440
$39,441 – $49,720
$49,721 – $60,000
$60,001 – $70,280
$70,281 – $80,560
If more than $80.560 enter amount here
Terms and Conditions
?
Declaration Statement:
I state that the information I have provided in this application is true and correct. I agree to provide proof of CARE eligibility if asked. I agree to inform Southern California Gas Company (SoCalGas®) if I no longer qualify to receive the discount. I understand that if I receive the discount without qualifying for it, I am required to pay back the discount I received. I understand that SoCalGas can share my information with other utilities or agents to enroll me in their assistance programs.
I Accept the Terms and Conditions