City of Richland Helping Hands Donation Form

The Helping Hands program is designed to assist customers in a time of need and is managed by the Benton Franklin Community Action Committee.

There are several donation options for the Helping Hands fund:

1. One Time Payment — Enter the amount you want to contribute.

2. Round Up Each month — The “Total Due” amount on your utility bill will be rounded up to the nearest dollar. The difference between the rounded dollar amount and the “Total Due” amount will be contributed to the Helping Hands fund.

3. Specified Amount — You may designate the amount you would like to contribute each month.

Customer-Account Number:

Contact Phone Number

Contact Email

Donation Type

One Time Payment

Round Up Utility Bill Each Month

Specified Amount Each Month

Amount Donating

Monthly Donation Amount

The amount listed in the Monthly Donation Amount section will be added to your utility bill payment each month.

Payment Type

Add to Next Utility Bill

Visa/Master Card

Full Card Number

Card Expiration Date

CCV (3-digit code on back of card)

I certify the information above to be correct and understand the amount will be pulled or billed as listed above.

Yes, I confirm and understand.

If signing up for re-occuring payments, please contact customer service prior to your next utility bill to cancel future requests.

Sign Here

First Name

Last Name

Choose how to sign

Draw Type

I agree to electronically sign and to create a legally binding contract between the other party and myself, or the entity I am authorized to represent.