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Energy Assistance Program

Emergency Home Energy Forms

Here are the forms that need to be completed for assistance under the Emergency Home Energy Assistance for the Elder program. This program is income based and for anyone over 60 year of age or has a household member that is over 60. We will also need everyone's current proof of income, Fl Id's on everyone, Social Security Cards on everyone, if you receive SNAP your paperwork on that also and if you rent the rental agreement and either your late/discount notice. TO set up an appointment, Please call 892-8165, You now need to come into the office


Application

Download Emergency_Home_Energy_Assistance_for_the_Elderly_Program_Application.pdf

Attachement N

Download attachn.PDF

Release

Download Authorization_for_Release_client waiver_8 20 15.pdf