Laserfiche WebLink
CITY UP <br /> SAN MARCOS <br /> Notice of Request for Utility Payment Assistance <br /> To: City of San Marcos <br /> Attention:Ali Pedersen, Brenda Munoz, Jaslyn Granado <br /> Phone: 512-393-8383 <br /> Fax: 855-759-2835 <br /> Email: u bass istance(a)sanmarcostx.gov <br /> Date: <br /> Name and Address of Agency Pledging <br /> City of San Marcos Utility Payment Assistance Funds: <br /> Utility Account#: <br /> Name: <br /> Address: <br /> Client Name: <br /> Amount of Assistance: <br /> Assistance from Fund: ❑City Funds ❑ Utility Donation Funds <br /> Agency Representative: <br /> Authorized Signature: <br /> Print name: <br /> COSM Use • <br /> Date Received User Initials <br /> Date Posted User Initials <br /> Date eDoc User Initials <br /> Comments: <br /> Last revised 2025-04-09 <br />