ALBAY POWER AND ENERGY CORP.

Legazpi City

APPLICATION FORM
SENIOR CITIZEN DISCOUNT PER R.A. 9994

NAME : ____________________________________________________________________________________

DATE OF BIRTH: _______________________________________ AGE: _____________________________

COMPLETE ADDRESS: _______________________________________________________________________

APEC ACCOUNT #: ____________________________ METER NO. _________________________

DOCUMENTARY REQUIREMENTS:

I. For Individual Senior Citizen (5%)

[ ] 1 pc. 2 x 2 Picture
[ ] Valid Senior Citizen’s (ID No. ______________)
[ ] Proof of Residency/Barangay Clearance

[ ] If no valid Senior Citizen’s ID, other valid IDs showing proof of age and citizenship:
[ ] Passport [ ] Driver’s License [ ] PRC Card
[ ] GSIS/SSS [ ] Voter’s ID [ ] Postal ID

If applying through a representative:

[ ] Special Power of Attorney
[ ] Picture of the senior citizen who is a holder of the latest power bill
[ ] Government-issued ID of the representative

CONDITIONS FOR AVAILMENT:

1. The kilowatt-hour meter (kWh) must be REGISTERED IN THE NAME OF THE SENIOR CITIZEN
RESIDING THEREIN for a period of AT LEAST ONE (1) YEAR.
2. The residential consumption must NOT EXCEED 100 KWHR/MONTH. (Art. 2, Sec. 1 of RA 9994).
3. The discount shall apply per household regardless of the number of senior citizens living thereat.
4. Senior citizens availing the discount per RA 9994 shall have to update his/her status with APEC every
JANUARY OF THE YEAR and should make an appearance at APEC.

II. For Senior Citizen Centers/ Residential Care Institutions/ Group Homes
[ ] Photocopy of the approved DSWD’s accreditation

CONDITIONS FOR AVAILMENT:

1. The Senior Citizen Centers/ Residential Care Institutions/ Group Homes must have been in operation
for at least 6 months.
2. The afore-stated institutions should have separate registration for its kwhr meters.

_____________________________________________ __________________________
Signature over Printed Name of the Applicant Date

EVALUATED BY: APPROVED BY:

___________________ ___________________________ ___________________

Account Officer Branch Head Date Approved