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Utility Bill(s) - [Most Recent Service Period Prior to Application for Grant] <br />➢ City of Santa Ana Municipal Utility Services <br />(MUS) <br />➢ Southern California Edison Electric Utility Service <br />(SCE) <br />➢ Southern California Gas Service (SoCalGas / <br />SCG) <br />➢ Phone Service Cable TV Service <br />➢ Cable TV Service <br />➢ Satellite TV Service <br />➢ Internet Access Service (DSL, Cable, Satellite, Smartphone) <br />Other forms of identification may be accepted <br />• Certification of a Financial Impact related to COVID-19 <br />Utility Bill <br />o Utility bill service address located within Santa Ana city limits <br />➢ Exception Cellular Phone/Smartphoneutilitybills -service address <br />or <br />billing address located within Santa Ana city limits <br />o Applicant/Recipient is named on the utility bill <br />o Past due in connection with the above -referenced eligible utilities <br />VIII. Reporting Guidelines: <br />Residents are required to certify they have experienced a financial impact (job loss or income <br />reduction equaling or exceeding a 25% reduction in household income) because of <br />COVID-19. The residents will need to provide the following: <br />Certification that theyhave an eligible past due utility bill(s) that requires <br />financial assistance <br />IX. Certifications: <br />Applicants will certify to the following: <br />• Applicant is reporting the household income on behalf of the service address <br />requested. <br />This grant program is supported with Coronavirus Aid, Relief, and Economic Security <br />Act ("CARES Act"), Public Law It 6-136, Section 601(a) of the Social Security Act, <br />to prevent, prepare for, and respond to the coronavirus ("COVID-19"). According to <br />Title 18, Section 1001 of the U.S. Code, it is a felony for any person to knowingly and <br />willingly make false or fraudulent statement to any department of the United States <br />Government. Resident understands that any willful misrepresentation on this <br />application could resultin a fine and/or imprisonment under provision of the United <br />States Criminal Code U.S.C. Title t8, Section 1001. <br />