HELP Loan Pre‑Application

Only fill out this form if you meet the following requirements:

  • You are the applicant, and you own the property (it may be tenant‑occupied)
  • The property is residential, or if mixed-use, it is primarily residential
  • The property does not contain more than four units
  • The property received a Notice of Defect for a repair required on the property’s water service pipe or sewer lateral, and/or related components
    A Notice of Defect is NOT required if you are applying to replace a lead service line
  • The payment agreements (if applicable) for the property are current
  • The property is served by an operable water meter
  • Applicant is not delinquent on their monthly water bill(s) for more than 2 cycles, for the property with the Notice of Defect and other properties owned by the applicant
  • You consent to the placement of a lien on the property for the amount of the total cost of the work

For Lead Service Line replacement only:
  • The property has a confirmed lead service line.
    Confirm the presence of lead by performing a lead test at home, or consulting with a registered plumber, or by notification via a Water Department inspector

Applicant Information

(First and Last)

(Number and Street)

(Your ten digit number without spaces or dashes)

(mm/dd/yyyy) NOT required if you are applying to replace a lead service line

Having an issue with the form?

Call 215-685-4901 to apply via phone.

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