Customer Service Form

Residential:  Senior Citizen Late Payment Waiver

Household Questions

 $0 - $1,265
 $1,266 - $1,715
 $1,716 - $2,165
 $2,166 - $2,615
 $2,616 - $3,065
 $3,066 - $3,515
 $3,516 - $3,965
 $3,966 - $4,415
 More than $4,416

Additional Requirement:  The Household / Family...

(Must select at least one item below.) *

 Has individuals 60 years of age or older
 Has individuals with Disabilities
 Has pre-school children in school (18 years or younger)
 Uses life-sustaining medical equipment
 Has extenuating circumstances as identified by CPS Energy or the City of San Antonio

Casa Verde

 I live in a single-family house; please enroll me in the Free Casa Verde program if I qualify. (CPS Energy will call you if you qualify, to complete the Casa Verde enrollment process.)
 No, I'm not interested

Account Information

10-digit number that starts with 300
Ex: 2105551234

Penalties for Fraud: 

Whoever obtains or attempts to obtain program enrollment for which he or she is not entitled, by means of willful false statements or other fraudulent means, may be considered guilty of a criminal offense and upon conviction may be fined and/or imprisoned.

By Clicking Submit: 

I certify that the information for the income of all household members 18 years and older is true and correct to the best of my knowledge and belief. I understand that the information will be verified to the extent possible; and that I may be subject to prosecution for providing false or fraudulent information.


I have read and acknowledge the general eligibility requirements to participate in the Affordability Discount Program.  I understand that submitting this application does not automatically enroll me in the Affordability Discount Program, and that the information I have submitted must be verified and approved prior to enrollment.

Enter Electronic Signature