Required Documents

Required Application Documents

The following are documents you must include with your application for the Low Income Home Energy Assistance Program and Universal Service Fund. Please read the list carefully. If you do not include all required documents, you will delay the processing of your application. Please send copies not original documents.

1.   Proof of Identification: Social Security cards for all members in the household and: Birth certificates for infants under the age of 12 months. Custody papers for minors not living with parents. Documentation for all foster children in the household. (A letter from DYFS or other social service agency)

2.   Proof of Income: All earned income information for everyone 18 years and older who resides in the household: (Please include all documentation which apply to members of your household) All documentation below if applicable. Unearned income is counted for every member of the household.

Earned and Unearned Income

a. If paid weekly submit paystubs for last 4 consecutive weeks within 8 weeks of the application submission date. If paid twice a month or every two weeks include 2 consecutive paystubs.

b. If self-employed: Copy of latest federal income tax statement with supporting documentation.

c. Pension, veteran and disability, Soc. Sec. or SSI benefits (including children benefits): Copy of checks or benefit award letter.

d. Unemployment benefits: Copy of award statement or 2 benefit pay stubs.

e. Child support/Alimony: Statement of total monthly support.

f. Rental Income: Lease for all tenants and/or rent receipts, or notarized vacancy agreement letter.

g. TANF or General Assistance (welfare): Award Letter or printout.

h. Interest or Dividends: Bank statement, Investment company statement.

Unemployed household members age 18 and over must have the following:

a.   Zero Income Statement (Applicant) (Not Notarized)

    b.   Zero Income Statement for other member of household (Not Notarized)

    c.   If a full time student (other than applicant), a letter which must be on school letterhead.

3.   If you own your home: (All documentation below, if applicable)

4.   If you rent: Copy of current lease agreement.

a. Proof of ownership: Copy of mortgage, tax bill, or deed.

b. If a Multi-unit building: document rental income from all tenants (lease, or rent receipts from all tenants, or notarized vacancy letter for vacant units only).

c. Probate sale contract.

d. Lease agreement indicating heating arrangements.

5.   Current energy bills: (Please include all that apply)

a. Gas and electric bill.

b. If your primary source of heat is other fuels such as oil or propane, provide a copy of your bill.

6.   Proof of U.S. Citizenship or Legal Residency Status: (Please provide one of the following)

a. Social Security card.

b. Copy of Medicaid/Medicare card.

c. Documentation from U.S. Department of Citizenship and Immigration Services.

d. USCIS Temporary Work Permit.

7.   Public Housing/Rental Assistance: Your Housing Authority proof of residence letter or lease agreement.

8.   Cooling applicants only: Submit doctor’s note stating the need for cooling, plus all other documentation above, if applicable. (Original doctor’s letterhead only; NO copies will be accepted)

* Please Note:  In certain cases, additional documentation may be required. If you cannot provide a required document, please call your LIHEAP/USF application agency. In some cases, you may be able to substitute it with a different document.