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Applicants must complete all sections of the form to determine eligibility and apply at the local agency office serving their county.
To qualify for crisis assistance, applicants must have a disconnect notice or be in a utility emergency situation.
All household members' income must be verified, including self-employment records if applicable.
The application requires details about home ownership status, landlord information, and whether energy costs are included in rent.
The application includes a section to indicate interest in weatherization services, although it is not an application for those services.
Applicants must provide proof of income, child support, unemployment benefits, and other relevant financial documents to apply for assistance.
Applicants have the right to appeal decisions regarding their application and must provide truthful information under penalty of perjury.
