UTILITY ASSISTANCE REQUIREMENT FORM
“PLEASE READ CAREFULLY”
The following information must be provided to Southeastern Arizona Community Action Program, Inc. (SEACAP) to determine if you are potentially eligible to receive utility assistance.
Your application will not be completed if any of the required documentation is missing. There may be additional information required depending on your situation.
- Proof of gross income for the last thirty (30) days (from the date you apply), for everyone
- Social Security Cards for all household members (Applicant must have original card)
- Picture I.D. for applicant only
- Proof of citizenship for applicant only:(Certified Birth Certificate, Certificate of Live Birth signed by hospital official and parent, Certificate of Naturalization, Religious record created within threemonths after birth, U.S. Passport, American Indian census record or Tribal Enrollment Card) OR Proof of U.S. legal residency for applicant only: Original Permanent Resident Card
- Utility bills (all pages received from utility company)last thirty (30) days from the date you apply). Deposit statements and/or propane quotes must be on company letterhead and include your name, address, account # & must be signed by company employee and dated.
- Current DES/FAA Award letter or printout for cash assistance dated within last 30 days.
If you have any questions prior to your interview, please call the number listed below or they can be answered during your interview.
Toll Free: 1-800-293-1144