How to Fill Out the Energy Assistance Program Landlord Affidavit
- Click ‘Get Form’ to open it in the editor.
- Begin by entering the applicant's information. Fill in the Applicant Name, Date, Address, Phone, City, State (IN), and Zip Code accurately.
- Next, move to the Utility Information section. As the landlord or authorized designee, indicate whether heating costs are included in the tenant’s monthly rent payment or if they are the tenant's responsibility by checking the appropriate boxes.
- Select the primary heating source from the provided options. Ensure you check only one box that best describes the heating method used.
- Input how much the tenant pays each month in rent in the designated space.
- Confirm if the primary heating source is operable by checking 'Yes' or 'No'.
- Finally, provide your name and signature as the landlord or authorized designee along with your address, date, city, phone number, state, zip code, and optional email.
Start using our platform today to complete your forms online for free!
Fill out other organization or government agency online
It's free
It's free
See more other organization or government agency versions
We've got more versions of the other organization or government agency form. Select the right other organization or government agency version from the list and start editing it straight away!
Security and compliance
At DocHub, your data security is our priority. We follow HIPAA, SOC2, GDPR, and other standards, so you can work on your documents with confidence.
Learn more