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Rebate Program Application

  1. Utility Rate Rebate Program

    On August 18, 2022 the City Council approved the City’s American Rescue Plan Act (ARPA) Expenditure Plan which included $1,000,000 in direct residential assistance by way of a Utility Rate Payback Program.  Because the City provides no utility services, we are partnering with Jurupa Community Services District and Rubidoux Community Services District for this program.  Residents of Jurupa Valley receiving water service from either of these agencies will receive an automatic rebate on their water bill.  For those residents mainly living in apartments or mobile home communities that do not receive water bills from the utility agencies, the City has created this online application for you to receive a $25 dollar PrePaid Visa Card.

  2. This program is for Jurupa Valley residents only. You must have a verified address located in the City of Jurupa Valley. Verification is confirmed by submitting a utility bill (SCE or gas bill). The utility bill address must match the current address of residency.

  3. (Or N/A if not applicable)

  4. 1(a)*

    Are you a resident of Jurupa Valley?

  5. This program is only for residents of Jurupa Valley.

  6. 2(a)*

    Do you currently receive a water, sewage, or trash bill from either Rubidoux Community Services District, Jurupa Community Services District, or Santa Ana River Water Company?

  7. Congratulations, if you currently receive your water bill you do not need to complete this application, you will receive a rebate from your water agency.

  8. 3(a)*

    Do you have difficulty paying utility bills due to COVID-19?

  9. American Rescue Plan Act Funds must be used to help households recover from the Negative Economic impacts of COVID-19.  If you experienced any hardships due to COVID-19 you should check "Yes" and continue. No records will be requested.

  10. 4(a)*

    Are you able to submit a utility bill with your name and current address on it? Utility Bills must be current  (within 6 weeks of submittal of the application).

  11. In order to verify that you live in the City of Jurupa Valley a utility bill is required to be uploaded  as part of the application

  12. Document Upload

    Please upload current SCE (Southern California Edison) or Gas bill with matching address. The name and address on the bill must match the applicant's name and current address. The bill must be current. Bills older than six weeks from the date of the application submission will not be accepted. You must answer "yes" from question 4(a) to continue.

  13. Accepted file formats: PDF, JPG, GIF, PNG

  14. Acknowledgement and Authorization

    By submitting this form, I understand that this rebate opportunity is being provided by the City of Jurupa Valley to provide relief for residents impacted by COVID-19. I understand that to receive these grant funds I must be a resident of the City of Jurupa Valley and acknowledge that the residency must be verified by the City of Jurupa Valley. By submitting this form, I certify that the above statements included in this application are true and correct to the best of my knowledge.

  15. Provide the full name of the person that is authorizing the submission of this form. This will serve as your electronic signature.

  16. Provide the date for the authorization/electronic signature.

  17. If you have any questions please call (951) 332-6464 ext.143 or email:

  18. Leave This Blank:

  19. This field is not part of the form submission.