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Payment Services

Extended Due Date Enrollment Form

Our Extended Due Date Program is for residential customers whose main source of total household income is from government or other low-income programs. Because assistance income may not arrive until around the 1st week of each month, a qualified residential customer can request to have their bill due date changed to fall in the middle of the month.

To apply for our Extended Payment Due Date Plan, simply contact us by phone or complete and submit the enrollment form below.

Extended Payment Date Plan Enrollment Form


Contact Information:

(10 or 12 digits)

(xxx-xxx-xxxx)

(xxx-xxx-xxxx)


Service Address

(xxxxx or xxxxx-xxxx)


Sources of Household Income

My main sources of household income come from


I normally receive my check on this day of the month.


Pepco can verify the above information with:

(xxxxx or xxxxx-xxxx)

(xxx-xxx-xxxx)


Agreement

I understand that all amounts due, except my current months charges, must be paid in full before my application will be accepted. I am enclosing the following in payment of all outstanding arrears on my account.


 I agree with the above

(box must be checked in order
to apply for this plan)


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Agreement check box must be checked in order to apply for this plan


 Note: * Items are required