Application Process

ALL PROGRAMS ARE AVAILABLE WITH THIS APPLICATION ONLINe

Energy assistance paper application

The Energy Assistance Program uses the same paper application as the Weatherization and Heater Repair program. Please click on the link below, download and mail or fax all documents to our office. Only fill out the information as it is needed for your family structure.

Documents needed for HEA Assistance

1. Copies of all Social Security Cards for Everyone in the home

2. Copies of all Income: Everyone in the home over the age of 18 (We MUST have all income listed)
If the household has no form of income, you must fill out the Affidavit of No Household income and this will be sent to the state for final approval.

If someone has “0” income over the age of 18, they must sign the Affidavit of No Income for member and DCA will verify.
Copy of Social Security Benefits award letter, if applicable (Including children benefits) or Copy of 1099 End of Year Statement for all Social Security if you do not have the award letter
Copy of SSI Monthly Benefit Statement

Samples of all other income may include:

Child Support
Food Stamps
Pensions
TANF
Wages
Rental Income
Unemployment benefits
Interest or Dividends

3. Proof of ownership

Single Family Owners: Copy of current tax bill
Mobile Home Owners: Copy of Title showing the address to be serviced and Lease agreement
Lease Agreement

4. Current energy bills ALL PAGES

Heating bill (Gas, oil, propane, etc)
Electric bill

** All documentation needed to complete Application will need to be provided by the client. Additional information may be required in certain circumstances.**

Energy Assistance Application DOCUMENTS TO DOWNLOAD

HEA APPLICATION

As a program funded by the Federal Government, we are obligated to verify all information provided, including Household income.

MONTHLY HOUSEHOLD EXPENSE FORM

This is only needed if someone over 18 is not a full time student and receives no income listed above.

ZERO INCOME STATEMENT FAMILY MEMBER

Cooling assistance to income-eligible households for which there is medical evidence that the health will be seriously endangered.

PHYSICIANS CERT COOLING BENEFIT

Tenant Lease Verification Form
(This form is to be filled out only by the landlord and /or superintendent)

TENANT LEASE VERIFICATION FORM

Once you have completed the application please send it to us.

SEND APPLICATION

Weatherization and Heater Repair Paper Application Process

The Weatherization Assistance Program and Heater Replacement Program use the same application process. If your home has not been weatherized or had a heater replacement in the last 20 years you may be eligible for both programs or one or the other.
Please click on the link below to begin your process. After you have completed the application you can send it in the mail, drop it off at our office in Bridgeton, NJ, send it through our e-fax phone number or take it to one our our partners listed on our partners page.

Please only fill out the information as it is needed for your family structure.
Documents needed for Weatherization Application

Copies of all Social Security Cards for Everyone in the home
Copies of all Income: Everyone in the home over the age of 18 (We MUST have all income listed) If the household has no form of income, you must fill out the Affidavit of No Household income and this will be sent to the state for final approval.

If someone has “0” income over the age of 18, they must sign the Affidavit of No Income for member and Form 8821 for tax verification
Copy of Social Security Benefits award letter, if applicable (Including children benefits) or Copy of 1099 End of Year Statement for all Social Security if you do not have the award letter
Copy of SSI Monthly Benefit Statement
Samples of all other income may include:

Child Support
Food Stamps
Pensions
TANF
Wages
Rental Income
Unemployment benefits
Interest or Dividends

3. Proof of ownership (home cannot be listed for sale, tax sale and all city utilities must be current on tax bill)

Single Family Owners: Copy of current tax bill
Mobile Home Owners: Copy of Title showing the address to be serviced and Lease agreement

4. Current energy bills (all pages)

Heating bill (Gas, oil, propane, etc)
Electric bill

** All documentation needed to complete Application will need to be provided by the client. Additional information may be required in certain circumstances.**

weatherization and heater repair DOCUMENTS TO DOWNLOAD

weatherization APPLICATION

This is only needed if the entire household has no income. We will need verification of what is supporting the home via notarized letter of support and IRS letter 8821 for IRS verification.

This is only needed if someone over 18 is not a full time student and receives no income listed above. Will also need to sign the 8821 for IRS verification.

This is only needed if someone in your home does not have a social security number. We must have copies of all the cards submitted with the application.

NO INCOME eNTIRE FAMILY

This is only needed if the household claims zero income. Otherwise this is not needed.

NO INCOME TAX FILING FAMILY

Please use this form for emergency evaluation of heater replacement

EMERGENCY SERVICES

WX. NO INCOME fAMILY MEMBER

This is only required if a member of the household does not have income and is not included in the main household tax return.

WX NO INCOME TAX FILING MEMBER

Only needed if zero income forms are used.

IRS 8821

NO SOCIAL SECURITY MEMBER

Only needed is zero income forms and no income tax filing are used.