Electric Rate Discount Application

| Resume a previously saved form
Resume Later

In order to be able to resume this form later, please enter your email and choose a password.

Password must contain the following:
  • 12 Characters
  • 1 Uppercase letter
  • 1 Lowercase letter
  • 1 Number
  • 1 Special character
This is a discount given by Peninsula Light Co. to low income households where the PLC member is a senior citizen (62+) or permanently disabled.
Eligibility Criteria
  • Your household must meet our current income guidelines.  These guidelines change every year.
  • Your PLC account has been active for at least 6 months.
  • You reside at the service address year-round (300+ days).
  • You are either 62 years old or older or permanently disabled (with documentation).
Application Process
  1. Complete and submit this form, including uploads of required documentation
  2. Penlight will review your application, and may contact you if additional documentation is needed
  3. You will be notified of the approval or denial by email or regular mail
  4. If approved, the discount will begin on your next billing cycle.
Ongoing Requirements
  • The discount can be renewed each calendar year, if your eligibility continues.
  • Please notify PLC within 30 days of any changes to eligibility, e.g. income, number of household members, or change of service address.
Documentation (required for all adults (18+) in the household)
  • Government-issued photo ID (driver's license, etc.).
  • Social Security card(s) (birth certificates are acceptable for minors).
  • If disabled, your Social Security Disability award letter.
  • Documents showing the last 3 months of income (including Social Security, pensions, pay stubs, etc.).
  • Proof of health care premiums that have been paid (for example insurance or Medicare statements).
  • For any adult (18+) in the household with no income, please submit a brief statement describing the current situation and how essential living needs are being met.

Page 2

Connector Information


Applicant(s)

Your account number is 4 to 6 digits long





Please enter the phone number like this ###-###-####

MM/DD/YYYY (Please include "/" symbol)




MM/DD/YYYY (Please include "/" symbol)





Monthly Income
Total monthly household income for those age 18 and over.




If no deductions please enter 0

This will be calculated automatically for you
Supporting Documentation
Proof of income for those age 18 and over.

Such as: Award Letter or Bank Statements

Additional Residence Information


Please explain

Leave blank if unknown.



Please type your full name. Limited to 25 characters.

I certify that the information I have provided on this application is accurate to the best of my knowledge. If I have provided inaccurate information on this application, which results in my receiving assistance for which I am not eligible, I will be required to repay Peninsula Light Company the cost of the rate discount.