HOME ENERGY ASSISTANCE

The following information is needed to process your application for energy assistance through LIHEAP. If you arrive to your appointment without the documentation listed below, you will be required to reschedule through our automated appointment system (1.850.308.1472). Please be aware that you must have all documentation that pertains to your household before you may complete an application for energy assistance. The documents necessary to complete your application for energy assistance are as follows:

1. 1. • Valid Florida IDs for every household member 18 years of age or older. Birth certificates or valid voter registration cards for Escambia County may be used in lieu of a valid Florida ID. If interested in Head Start. please bring birth certificates for child(ren).
      • Social Security cards for everyone in the household. Printed immunization records from the health department for minors are acceptable if the complete social security number is shown. If you are missing a social security card for a household member, you must obtain one from the Social Security Administration before service may be rendered.
      • Current Electric bill (Heating bill required along with the electric bill October 1 thru March 30). If you have a final bill, you must get a letter from the power/gas company showing amount(s) required to restore service, as well as the current service address. Please be aware that returned item charges and revenue protection charges must be paid up front prior to completing your application.
      • Custody papers for all minors living in the home who are not your biological children. Documentation is also required for previous applicants whose children are no longer in the household (i.e., legal custody/guardianship documentation verifying transfer of custody)
      • Income documentation for all household members who has received income for last thirty days prior to application date:

Wages paid bi-weekly: bring last three check stubs
Wages paid weekly: bring last five check stubs
Wages paid once per month: bring last two check stubs

**Note: A letter from your employer on company letterhead or stamped with a company stamp is required if you are missing any check stubs or if you recently began or ended employment.

1. 1. • Social Security Award Letters verifying the monthly income for the current year. If you do not have the current letter, you may have one faxed/mailed to you by calling 1-800-772-1213 or you may visit www.ssa.gov.
      • Documentation of self-employment income for the last thirty days prior to date of application. Plasma donors must present a donor report showing income for the last thirty days. If you scrap metal, a report is required from the company verifying your scrap income for the last thirty days.
      • Wage Determination Transcript showing weekly benefit amount for clients receiving unemployment benefits.
      • Child Support verification for each child in the household (must provide verification that you do not receive child support benefits if you do not report child support income but have minor children in the home and one biological parent is absent).
      • Cash Assistance (TANF): Bring printout of income for last thirty days (month of application).
      • Verification of Food Stamps (Food Stamp Award Letter) *Verification is required for all Food Stamp recipients. I/you do not report food stamp assistance but your income is less than $1025 monthly, you must provide verification that you do not receive food stamps. Foods tamp verification must list case members as well as benefit amount for month of application. This documentation is used to verify household size and, therefore, must be accurate.
      • Current Pell Grant Award Letter or financial aid documentation for the current semester
      • Current Lease or Notarized Tenant Verification Form (available at our office and must be completed & notarized by property owner) or Proof of Homeownership (i.e., current mortgage statement, tax document or deed). If someone appears on your home ownership verification who does not live in your household, a notarized statement is required verifying the person’s current living address with a valid telephone number. If the person who appears on verification is deceased, an obituary or death certification will be required. HUD/Area Housing residents must have current HUD lease (Contract Amendment Notice/ Notice of Rent Adjustment/HUD form 50059) Please note, documentation of utility reimbursement payments may be required–even if you haven’t received a payment.
      • Notarized statement from family member/friend who assists with your expenses (This statement must provide the person’s name and contact information, along with the exact amount the person is providing you each month)
      • Notarized Self-Declaration form (available at our office). This form is required for any household member 19 years of age or older whom reports no income
      • Notarized Bill Explanation Form completed and notarized by person whose name appears on the bill. If the person is deceased, you must obtain service in your own name or the name of another agreeable party.

INCOME GUIDELINE PDF