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Senior Citizen Discount Form - 0

This document is an application form for a 5% discount on electricity consumption for senior citizens aged 60 and above in accordance with Republic Act 9994. The application requires the applicant's personal details including name, age, gender and contact number. It also requires the applicant's account number, meter number and address. The applicant must meet the following conditions: be a registered member-consumer for at least one year, reside at the stated household, have a monthly consumption not exceeding 100KWH, and provide proof of age, residence, and billing. The application is subject to confirmation by CAGELCO I and must be renewed annually. Any misrepresentation will result in disqualification from the discount.

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Johven Ramirez
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267 views1 page

Senior Citizen Discount Form - 0

This document is an application form for a 5% discount on electricity consumption for senior citizens aged 60 and above in accordance with Republic Act 9994. The application requires the applicant's personal details including name, age, gender and contact number. It also requires the applicant's account number, meter number and address. The applicant must meet the following conditions: be a registered member-consumer for at least one year, reside at the stated household, have a monthly consumption not exceeding 100KWH, and provide proof of age, residence, and billing. The application is subject to confirmation by CAGELCO I and must be renewed annually. Any misrepresentation will result in disqualification from the discount.

Uploaded by

Johven Ramirez
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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CAGAYAN I ELECTRIC COOPERATIVE, INC.

Maddarulug, Solana, Cagayan


Contact Nos. 078-844-1595 ; 09175782437

APPLICATION FOR AVAILMENT OF 5% DISCOUNT FOR SENIOR CITIZEN ON ELECTRICITY


CONSUMPTION PER R.A. 9994
Control #: ______________________
Account #: _________________Meter #: ___________________ Address: _____________________________________
Name of Senior Citizen: _________________________________ Age: ___ Gender: ___ Contact #: ________________
I hereby apply for the availment of the five percent (5%) discount on my electric consumption subject to the
following conditions set forth in accordance with the ERC implementing Rules and Regulations of the Republic Act
9994, otherwise known as Expanded Senior Citizen Act of 2010.
1. That I am a registered Member-Consumer of CAGELCO I for at least one year.
2 That I am residing in the above stated household with Account and Meter Serial Number declared above.
3. That my monthly electric consumption does not exceed 100 KWH.
4. That I agree to present and submit the following requirements:
a. Proof of Age and Citizenship (any of the following)
i. Birth Certificate or any proof of birth; or
ii. Valid Senior Citizen Identification Card issued by the Office of Senior
Citizen’s Affairs (OSCA) in the city or municipality where the elderly resides; or
iii. Philippine passport or any gov’t identification card (Driver’s license, Voter’s ID, SSS/GSIS,
PRC card, Postal ID)
b. Proof of Residence (any of the following)
i. Barangay certificate; or
ii. Affidavit of two (2) disinterested persons duly notarized and has known
the Senior Citizen for not less than one year
c. Proof authority (if through a representative)
i. Valid ID of the representative; and
ii. Authorization letter duly signed or thumb-marked by the Senior Citizen
consumer which shall be valid only for a period of one(1) year from date of issuance.
d. Proof of billing
i. Copy of electric bill issued in the name of the senior citizen.
5. That this application is subject for confirmation/validation by CAGELCO 1, and if approved, my
application is renewable annually.
6. That any misrepresentation regarding my application is a clear ground for my disqualification to avail of
the said discount.
Signed this _____ day of __________________, 20___ at____________________________,Cagayan

________________________________________
Signature over Printed Name of Applicant

VERIFICATION SLIP (to be filled out by CAGELCO 1 Personnel)


ISD FSD
Registered Name: ________________________________ Account #: ____________________________________
Address: ________________________________________ Meter Serial #:_________________________________
Date Applied: ____________________________________ Route #:_________________ Seq #:_______________
OR #: ________________________MC ID#: ___________ Classification: _________________________________

Verified by:
_________________________ _____________ __________________________ ______________
ISD Personnel Date FSD Personnel Date

Checked by: Recommending Approval: Noted by:

JENNELYN F. MAPPATAO FRANCISCA D. OBISPO ENGR. TITO R. LINGAN


Sub-Office Head, Area 1 ISD Manager General Manager

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