DeKalb County District 1 Water Grant Conference Request

The DeKalb County District 1 Water Grant was awarded to SVdP Georgia to assist our clients with their water bills in District 1 of DeKalb County. This is a reimbursement grant and you are required to submit appropriate documentation to show that the client meets the grant criteria. The reimbursement will be for assistance provided from November 17, 2021 to December 31, 2022, or until funds are exhausted.

Here is the information for the income limits:

# in household                               Maximum income
1                                                        $48,300
2                                                        $55,200
3                                                        $61,100
4                                                        $68,950
5                                                        $74,500
6                                                        $80,000
7                                                        $85,500
8                                                        $91,050

 

PLEASE SUBMIT THE FOLLOWING FORM FOR REIMBURSEMENT:

"*" indicates required fields

Conference/Caseworker Information

Name of Person Submitting Request*

Client Information

Client Name*
Address*
MM slash DD slash YYYY
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    PLEASE CHECK THIS BOX TO CONFIRM THAT CLIENT LIVES IN DISTRICT 1*
    PLEASE CHECK THIS BOX TO CONFIRM THAT THIS CLIENT MEETS THE INCOME LIMITS*
    PLEASE CHECK THE APPROPRIATE BOX TO CONFIRM THAT THIS CLIENT HAS A COVID-19 IMPACT*
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