Lifeline Recertification Form 2024-25 

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NOTICE TO LIFELINE PLAN ENROLLED HOUSEHOLDS: Recertify to avoid your benefits expiring on October 1, 2024.

The Detroit Water & Sewerage Department (DWSD) Lifeline Plan Policy and funders require all participating households to recertify and re-enroll on or after October 1, 2024.

DWSD will unenroll clients from Lifeline on October 1, 2024, at which time you will receive a regular monthly bill and will no longer be protected from shut-off if you do not re-enroll by October 31, 2024.

Lifeline households must make the monthly tiered payment of ($18, $43, or $56)) in full each month. The Lifeline plan policy clearly states: "If the customer receives two (2) consecutive bills with a balance forward due to non-payment or partial payment, the customer is automatically unenrolled from the Lifeline Plan."
I hereby allow Wayne Metropolitan Community Action Agency, its agents, employees, sub-contractors or affiliates to communicate with and request information from all housing, utility and income providers listed on Wayne Metro's related forms and to enter my personal information into the applicable program databases. I also confirm I have provided information about additional family members with their consent and approval. This release expires two (2) years from the date of application. I agree that copies of this authorization may be used for the purposes stated above. I understand and agree that Wayne Metro may also use my personal information for data analysis and metrics purposes.












Consent and Certification

I certify that the information provided on this form is true and accurate to the best of my knowledge.