GCWSA CRF Customer Application
Coronavirus Relief Funds for GCWSA Customers that have experienced an economic hardship due to the COVID-19 crisis. The eligibility dates are March 16, 2020 through September 15, 2020. Applicants must provide proof (VA Employment Commission Monetary Determination Form and/or Employer letter on official company letterhead to include dates affected) of the hardship with the application for review. All fields are required. Please submit required documents to admin.wsa@greensvillecountyva.gov
Email address *
First Name *
Last Name *
Service Address *
City *
State *
Zip Code *
Telephone *
Account # *
Last four of SSN *
Have you experienced any of the following due to COVID-19? (Check all that apply) *
Required
Effective dates of items checked above *
Verification Documentation is Required (Please select which option applies. Email all documentation to admin.wsa@greensvillecountyva.gov *
A copy of your responses will be emailed to the address you provided.
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