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Landlord Affidavit for Energy Assistance Program 2026
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- Click ‘Get Form’ to open it in the editor.
- Begin by filling out the 'Applicant Information' section. Enter the applicant's name, date, address, phone number, city, state (IN), and zip code.
- Proceed to the 'Utility Information' section. Indicate who is responsible for heating and electric costs by checking the appropriate boxes. If applicable, provide a utility statement copy.
- Complete details about the primary heat source and number of household members. Specify if the primary heat source is not working and select the dwelling type.
- In the final section, print and sign your name as the landlord, along with your address, date, city, phone number, state, zip code, and optional email.
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Related links
ENERGY ASSISTANCE PROGRAM (EAP). LANDLORD AFFIDAVIT. Landlord: Please complete this affidavit on behalf of your resident who is applying to receive benefits to.Read more
Feb 28, 2020 This is a summary, based on the Final Rules published in March 1996, of the activities that are eligible and in- eligible for assistance underRead more
If this is the case, you will need to complete an Affidavit in Certification of Zero for any household member age 18 and over. Please note: Most householdsRead more