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Liheap no income form 2025

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The document outlines the requirements for adults in a household with zero income to certify their lack of income for the Low Income Home Energy Assistance Program (LIHEAP). Each adult must complete a section affirming they have received no income over the past thirty days, authorize verification of their tax returns, and acknowledge potential legal consequences for misrepresentation.

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What is a no income statement for LIHEAP?

The information that must be reported on a LIHEAP No Income form includes: name, address, telephone number, household size, social security numbers of all household members, proof of residency, and a signed and dated statement indicating that the household has no income.

How to write a statement of no income?

I hereby certify that I do not individually receive income from any of the following sources: a. Wages from employment (including commissions, tips, bonuses, fees, etc.); b. Income from the operation of a business; c. Rental income from real estate or personal property; d.

What counts as proof of no income?

Any documents from state or federal benefit agency that show zero income. These can be eligibility notices for food stamps or Medicaid for instance. If zero income is due to the loss of a job, this can be proven by a termination letter or a notice of severance pay on your last paycheck stub.

Does LIHEAP verify income?

If the recipient receives social security, SVES is checked. For those who are self-employed, they must submit tax returns. We will use SEVS to check proof of income, and therefore identify, for applicants who do not provide proof of social security income.

What does zero income statement mean?

A Zero Income Statement is a formal declaration used to certify that an individual currently has no income from any sources.

zero income affidavit illinois

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What documentation is needed for LIHEAP?

Applicants Current Drivers License or Birth Certificate (If the applicant has an award letter, an open Food Stamp case or a Benefit ID card in their name, you can use this if unable to provide your DL or Birth Certificate). 2. Social Security cards for everyone in the household.

How to write a proof of no income letter?

I certify that I have not been employed, self-employed, completed odd jobs, or had any source of income including gifts or loans during the past 30 days. For the amount of $. I received my last payment from this source on or about .

Liheap no income form 2025

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