“REQUIREMENTS FORM”


PLEASE READ CAREFULLY


You must bring the following information with you to your interview.  Assistance will not be provided if any of the requested information is missing.  If you have any questions, please ask that it be explained to you. 


WEATHERIZATION / UTILITY REPAIR & REPLACEMENT ASSISTANCE:

1. Proof of gross income for the last thirty (30) days (from the date you apply), for everyone in your household. (I.e. Check/Pay stubs, Award letters: Social Security, SSI, SSDI, Workman’s Compensation, etc. Payment history: Unemployment, Child support, etc. Daily Ledger/Recipient letter: Self-employment and Odd jobs.) No bank statements accepted, must be from originating source. Zero income requires proof of how you have been meeting your expenses in the past 60 days.

2. Social Security Cards for all household members (Applicant must have original card)

3. Picture I.D. for applicant only

4. 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 three  months 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

5. Paid property taxes or exempt tax form for the current year.

6. Current mortgage statement

7. If your home is paid in full, you must bring ONE of the following:

  •  Deed of Release of Debt
  •  Release of Reconveyance
  •  Affidavit of Property Value
  •  Mobile Home Title


8. Landlord’s paid property taxes for the current year and formal current lease agreement (if renting). 


9. Current electric, gas, and/or propane bill

10.  Current DES/FAA Award letter or printout for cash assistance dated within last 30 days.