Forms

• 2023 English Application (All Programs Open Except Utility Assistance for Civilians) 
• 2023 Spanish Application 

Please see supplemental forms below. Failure to provide these forms, if applicable, will delay the processing of your application and may result in denial of services.

Verification of Income 

This form is to be used if a member of the household who is 18 years old or older is working, but is unable to obtain paycheck stubs.

Declaration of Income/No Income Statement 

This form is to be used if a member of the household who is 18 years old or older is not working, is self-employed and does not receive paychecks, or receives a pension that does not provide documentation.

Landlord Permission Form

This form is for households that are applying for weatherization services that rent their home. The form must be completed by the landlord.