Customer Assistance Program (CAP)

As a participant in the Columbia Gas of Pennsylvania’s Customer Assistance Program, I agree to accept all of the program conditions as listed below. Failure to agree or follow through on any of the accepted conditions will result in removal from the CAP Program. I agree to:

• Show proof of gross monthly household income when I apply.
• Re-verify gross monthly income every other year; unless I receive a LIHEAP Grant and it is posted to Columbia Gas.
• Notify the Universal Service Representative at 1-800-537-7431 of any changes in income, household size or residence.
• Pay the CAP payment, monthly, by the due date.
• Resume paying my full CAP installment when my LIHEAP grant is exhausted.
• Call Columbia Gas CAP immediately if I am no longer able to afford my CAP payments to avoid getting behind on my bill.
• Cooperate with Columbia Gas Warm Wise LIURP Program if I meet the eligibility requirements.
• Authorize Columbia Gas to share household data with our CAP administrator, such as Dollar Energy Fund, in order to process CAP enrollments and reverifications. Such sharing and use of the information shall be consistent with applicable law.
• Authorize Columbia Gas to use information received from the Dept of Human Services LIHEAP program to reverify my income.
• Accept any program change pursuant to Commission regulations.

In addition, I confirm that the facts set forth in my CAP application are true and complete to the best of my knowledge. I also hereby authorize Columbia Gas to further verify my household income, as Columbia Gas deems appropriate. I understand, agree and accept that false or incomplete statements on my CAP application will be cause for rejecting my application or removal from the Program.