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How do I fill this out?

To fill out the National Grid Financial Hardship Statement, begin by entering your personal and account information. Then, list all household members along with their income details. Finally, sign and date the form before submission.

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How to fill out the National Grid Financial Hardship Statement MA and Nantucket?

  1. 1

    Enter your personal and account information.

  2. 2

    List all household members and their income details.

  3. 3

    Provide additional information if needed.

  4. 4

    Sign and date the form.

  5. 5

    Submit the form to National Grid.

Who needs the National Grid Financial Hardship Statement MA and Nantucket?

  1. 1

    Customers experiencing financial hardship need this form to apply for assistance.

  2. 2

    Households with multiple income sources need this form to document their financial situation.

  3. 3

    Customers looking for discount rates on their utility bills need this form.

  4. 4

    Customers requested by National Grid to provide income verification need this form.

  5. 5

    Any customer who needs to officially certify their financial information for National Grid needs this form.

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  1. 1

    Open the National Grid Financial Hardship Statement on PrintFriendly.

  2. 2

    Use the text tools to fill in your personal and household information.

  3. 3

    Add or update any additional sections as needed.

  4. 4

    Apply your digital signature using the signature tool.

  5. 5

    Save and download the edited PDF for submission.

What are the instructions for submitting this form?

To submit the National Grid Financial Hardship Statement, mail the completed form to National Grid, PO Box 960, Northborough, MA 01532-0960. Include all required information and ensure the form is signed and dated. For any questions, contact National Grid customer service using the phone number provided on your bill. It is advisable to keep a copy of the completed form for your records.

What are the important dates for this form in 2024 and 2025?

There are no specific dates mentioned for 2024 and 2025. Ensure timely submission of the form based on your current financial situation and National Grid's requirements.

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What is the purpose of this form?

The purpose of the National Grid Financial Hardship Statement is to assist customers in Massachusetts and Nantucket who are experiencing financial difficulties. By providing detailed household income information, customers can apply for discount rates on their utility bills. This form helps National Grid assess the financial needs of its customers and offer appropriate support.

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Tell me about this form and its components and fields line-by-line.

The form contains sections for personal information, household member details, income sources, and certification.
fields
  • 1. Customer Name: The full name of the customer applying for financial assistance.
  • 2. Phone number: The contact phone number of the customer.
  • 3. Service Address: The address where the utility service is provided.
  • 4. City: The city where the utility service address is located.
  • 5. Zip: The zip code of the utility service address.
  • 6. National Grid Electric Account: The electric account number with National Grid.
  • 7. National Grid Gas Account: The gas account number with National Grid.
  • 8. Household Members: Details of all people living in the household, including name, date of birth, income amount, and income source.
  • 9. Certification: The section where the customer certifies that the provided information is true and signs the form.
  • 10. Additional Information: Space for any additional information about household members and income sources.
  • 11. Signature: Signature of the customer certifying the information.
  • 12. Date: The date when the form is signed by the customer.

What happens if I fail to submit this form?

Failing to submit the National Grid Financial Hardship Statement may result in the inability to receive financial assistance or discount rates.

  • Loss of Discount Rates: Customers may lose eligibility for discount rates without the form.
  • Service Disruption: Failure to provide required information may lead to potential service disruption or disqualification from assistance programs.
  • Delayed Support: Not submitting the form can delay financial support and assistance from National Grid.

How do I know when to use this form?

Use this form when you are experiencing financial hardship and need to apply for assistance with National Grid.
fields
  • 1. Applying for Discount Rates: Use the form to apply for reduced rates on your utility bills.
  • 2. Income Verification: Submit this form when requested by National Grid to verify your household income.
  • 3. Financial Assistance: Fill out the form to seek financial assistance during difficult times.
  • 4. Household Documentation: Use this form to document household members and their income sources.
  • 5. Requesting Public Benefits: Customers receiving certain public benefits may use this form to provide necessary information to National Grid.

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Use the signature tool to add your digital signature to the document.

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What happens if I make a mistake while editing?

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Where do I submit the completed form?

Submit the form to National Grid using the provided mailing address or other contact information.

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National Grid Financial Hardship Statement MA and Nantucket

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