The following forms will be required with your online LIHEAP application.
List of Documents Needed
Download List of Documents Here
A comprehensive list of all the necessary documents in order to apply for assistance.
VERIFICATION OF DISABILITY
Download Verification of Disability Form Here
If you claim that someone in your household has a disability – you must provide a current disability benefits letter. Death benefits do not qualify. If you do not have a benefit letter, you must have this verification of disability form completed by a Doctor and upload it into the online application.
ZERO $$: VERIFICATION OF INCOME & EXPENSES
Download Verification of Income and Expenses Form Here
If there is anyone 18+ on your application without income, you must complete this form for 0 income, and upload it into the online application.
LANDLORD/TENANT ENERGY ASSIST AGREEMENT
Download Energy Assist Agreement Form Here
If your landlord is the primary MLGW account holder, but your lease agreement has terms that state that you pay a portion of the utility costs when you pay your rent every month, you must have this form completed by your landlord and upload it into your online application. *YOU WILL BE ASKED TO PROVIDE THE LEASE AS WELL.
SELF- EMPLOYMENT INCOME FORM
Download Self-Employment Income Form Here
If your household wages are from self-employment, you must complete this form and upload it into your online application. *YOU WILL BE ASKED TO PROVIDE YOUR MOST RECENT TAX RETURN AS WELL.