Utility Assistance | The Senior Source

Your personal information is kept private and confidential. We do not share client information unless specifically authorized to do so.

Name*
First Last
Age*
Phone*
Email
Zip Code*
Please upload a picture of your ID
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Accepted file types: jpg, gif, png, pdf, Max. file size: 256 MB, Max. files: 6.
Which provider do you need assistance with?*
- Atmos Energy
- Ambit Energy
- TXU Energy
- Other
Account Number*
Consent*
Consent for Service
I hereby certify that all information provided by me is true and correct to the best of my knowledge. I also authorize the Elder Financial Safety Center at The Senior Source to contact my utility provider to obtain information regarding my account if necessary.

I understand that the Elder Financial Safety Center at The Senior Source provides utility assistance once a year, and if wanted, I can participate in other programs and services of the Center that can better my financial situation.
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