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Request For Waiver of Deposits and LPC PDF
Request For Waiver of Deposits and LPC PDF
Waiver Program
Starting September 15, 2021, residential ComEd To qualify, your household income must be at 80%
customers identified as meeting the requirements of or less of Area Median Income (AMI) for your county
“low-income residential customer or applicant” (and of residence, or you must be currently enrolled in the
eligible) under Sections 8-201.7 and 8 201.8 of the Illinois federal Lifeline program. Please complete a brief form
Public Utilities Act will have deposits and late payment and provide documentation regarding your household
charges waived. and household income.
ComEd residential customers currently receiving If you meet the eligibility requirements, we will return
LIHEAP (Low Income Home Energy Assistance Program) the deposit to you within 2 billing cycles.
or PIPP (Percent of Income Payment Plan program)
benefits under the Energy Assistance Act have been • The deposit will first be applied to any outstanding
automatically approved and do not need to submit a balance on your account. If there are any remaining
request. funds, they will automatically be returned to you by
check.
If you currently live in a zip code listed here, you only
need to complete and submit the form. No additional • If your account is current, the deposit will
documentation is needed. automatically be returned to you by check.
For other residential customers and service applicants, Renewal Deadline Details: For those customers who
to qualify, your household income must be at 80% submit their completed form on or before August 31,
or less of Area Median Income (AMI) for your county 2022, a Company designation of eligibility is effective
of residence, or you must be eligible for or currently through December 31, 2022. For those customers who
enrolled in a federal Lifeline program. Please complete submit their completed form on or after September 1,
a brief form and provide documentation regarding your 2022, a Company designation of eligibility is effective
household and household income. through December 31, 2023. The designation of
eligibility may be renewed annually through the above
process if and as long as the customer remains eligible.
Notwithstanding the foregoing provisions regarding the
duration of an eligibility designation, eligibility remains
subject to the statutory exception relating to tampering
with respect to waiver of deposits.
Deposit and Late Payment Charge
Waiver Program
Types of acceptable documentation to demonstrate • Loss of income documents (dated within the last 3
eligibility include, but are not limited to: months)
• Layoff/furlough notice
• Current income documents
• Unemployment application, approval letter, or
• Prior year state, federal, or Tribal tax return
benefit statement
• Social Security statement of benefits
• Unemployment or Workers’ Compensation
• Veterans Administration statement of benefits statement of benefit statement
• Retirement or pension statement of benefits • Lifeline program enrollment
• Unemployment or Worker’s Compensation • Completed No Income form, which is available at
statement of benefits ComEd.com/verification
• Divorce decree, child support award, or a similar
official document showing household income
• Supplemental Nutrition Assistance Program Please submit COPIES of your supporting
(SNAP) documentation and retain your originals.
• Supplemental Security Income (SSI) DO NOT SEND original documents or original IDs.
• Medicaid
• Federal Public Housing www.fcc.gov/general/
lifeline-program-low-income-consumers
Assistance
• Tribal-specific programs: Bureau of Indian Affairs
General Assistance, Tribally Administered
Temporary Assistance for Needy Families
(TTANF), Food Distribution Program on Indian
Reservations (FDPIR), Head Start
• Income at or below 135% of the Federal Poverty
Guidelines
• Veterans Pension and Survivors Benefit
Programs
Waivers and return of deposit not applicable to customers who have been identified as having benefited from tampering with a
ComEd service meter.
Eligibility for these waivers and return of deposit does not qualify you for the Illinois Low Income Home Energy Assistance
Program (LIHEAP), The Percentage of Income Payment Plan (PIPP), Emergency Rental Assistance Program (ERAP), or any other
utility financial assistance program.
County-Specific Household AMI Information Chart
ROCK ISLAND $42,750 $48,850 $54,950 $61,050 $65,950 $70,850 $75,750 $80,600
PHONE EMAIL
COUNTY
Are you eligible for or currently enrolled in a federal Lifeline program? YES NO
All the answers and documentation that I provided on this form are true and correct to the best
of my knowledge.
I know that willingly giving false or fraudulent information to get these waivers can result in
de-enrollment or being barred from receiving these waivers.
I understand that I must respond by the renewal deadline; if I do not timely respond, deposits and late
payment charges could be assessed.
I agree that all of the information I provided on this form and in any supporting documents that I
provide, if any, may be collected, used, shared, and retained by ComEd and its affiliates and vendors for
the purposes of implementing and applying the provisions of the Public Utilities Act on waivers of
deposits and late payment charges and energy efficiency measures or programs for low-income
residential customers, and programs for deferred payment arrangements and for extending the due
dates of ComEd bills.
SIGNATURE DATE
Your request will be reviewed, and a determination of eligibility will be sent to the email address if provided or you will
be notified via phone number.
Directions:
Missing documents will delay your application
Submit the completed application and supporting
documentation by mail or fax. DO NOT SEND original Copies of your supporting documentation must
documents or original IDs. be included with your application unless you live
in a zip code listed on page one.
Mail:
Attention - Waiver
P.O. Box 2550, Chicago, IL 60690
Fax: 443-213-3553