IQAP Application

Fort Collins Utilities partners with LEAP to save you more money on your utility bill. IQAP is a reduced electric, water and/or wastewater rate that provides 23% off certain components of these services.

You may qualify for IQAP if you received LEAP during the previous or current season and live in a household with an eligible Fort Collins Utilities electric, water and/or wastewater account.

Complete all fields below. Only complete applications will be accepted.
Information provided will not be shared or used for any other purpose.

1. LEAP Applicant Name *This question is required.

2. Best Email *This question is required. This question requires a valid email address.

3. Best Phone Number *This question is required. Include dashes (XXX-XXX-XXXX)

4. Name of Utilities Account Holder (if different from LEAP applicant)

5. Utilities Account Number *This question is required. Account number can be found on your utility bill or by calling 970-212-2900.
Include dash (XXXXXX-XXXXX)

6. Address: *This question is required.

Street Address

City

State

Zip

Affidavit
My signature below certifies all information on this application is true and accurate, the total household income for this residence qualified for current or previous season LEAP benefits, and the homeowner, whether an occupant or a landlord, agrees to the program terms. I further acknowledge that making a false, fictitious, or fraudulent statement or representation in this sworn affidavit is punishable under the criminal law of Colorado as perjury in the second degree under C.R.S. 18-8-503, and it shall constitute a separate criminal offense each time a public benefit is fraudulently received.

7. Consent to Contact *This question is required.

I consent for Utilities to contact me by email, telephone or mail regarding participation in IQAP program activities.

8. Moving *This question is required.

I understand that if I move, it is my responsibility to notify Utilities and ensure my IQAP rate is transferred to my new address.

9. Signature *This question is required.

Clear

Signature of

10. Date *This question is required. This question requires a valid date format of MM/DD/YYYY.

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