endstream endobj 2621 0 obj <>/Metadata 142 0 R/Outlines 266 0 R/Pages 2615 0 R/StructTreeRoot 309 0 R/Type/Catalog>> endobj 2622 0 obj <>/Font<>>>/Rotate 0/StructParents 0/Tabs/S/Type/Page>> endobj 2623 0 obj <>stream The Energy Crisis Intervention Program (ECIP) provides assistance to low-income households that are in a crisis situation. 5/20) HOME ENERGY ASSISTANCE PROGRAM APPLICATION . �x������4H #���ӿ O� endstream endobj startxref ldss-3421 (rev. 1919 0 obj <>stream please print clearly, and sign the form on page 5.complete the white boxes below in blue or black ink. h�b```�\6�!b`f`BF��#���֗Lyר����8s��N7�S Ng$9�j}T���бy������ �ɛ��T��ٖD��t!�U�m�դ�ls7m��_��L{M����⡩j���Z�t�~S?�OH �"�"�"�"�$��%q}Eh�Ҟ��`T�8�&�"�J e 1. �$�Ev_l�O&u�mOI�)���p6���nH @��7p46vt040 ���� ��Jt4p40� D���lv��@��y��e��a9]0���ޞ˼ /_��e��}��4#;33��C�Lw��S�� �����11�H� ��@3�0 �\? 2640 0 obj <>stream 0 ����6�ϮA�c���E����bV�� �a���1����� �R�[6�ۚ�Q�o׻�r�I��L簟����CΧU��k~�8��z�%��W�:_5�GQkf��$��ʑJf�%Q���~\5��:/Ȇ��4�cQ��3)˪������4��k�����22ޭ0������2/6w ���Yު�"k��6���T���sq�]ESB 5/17) home energy assistance program application please read the instructions attached to the back of the application.answer all questions.do not write in the shaded areas. h�bbd``b`�Ӂ�(�`S �q � If you are blind or seriously visually impaired and need this application in an alternative format, you may request one from your social services district. %PDF-1.6 %���� %%EOF 388 ]��앿Lے�( l,��{�:��x`���� �&��z�����^�0�߄U� ��V�!6iV=�u. To apply for Energy Assistance, you must complete all questions front and back and sign at the red “X”. The HEAP program is not an entitlement program. All can apply, but not all may qualify. h��Wmo�6�+��~h�bK��C��Y��á��aA>�/5�څ�^�?��T�M�]6�6�(��"��2*a�)�R&�&L*b��N�QLYb"�Rbb�[cͤ�9�d�(�,�D!��HY�R�`���MN�e�� ��Q�����%!�����0N��5A5z��V#�\�����$[5�@OD�A�0��1*�i����q� %�3���PElE\E|EBEbI��*�K���Kc��$�$�_�����R|���v@`���Rx��O�qz@�:����&��1A5�T. ;���ŀۭv^}���^�:�&��u��lv�X��q���e�#$�nGH���_��������Fp�����/�ֿ=�?��f��/�f�=���p��77w뷛���O�������O��������>�&}��ww��ؼ�y��y�$�o|Ϲ����'68���ۛ��k%%���w��Oy��AHq ���B�У��QG�q��W$T$V$U���)�u� �I�%�yb������K{B%!W�4�&�"�J�e� �Qc+�/�Ww�NJ�u�����& �Vă��j�+�A\E`4��g�Ћ��3b�ƀ���4zS���'�"�"�"�$.���%�x? b�����j��')�R�-�"m��$eV��Z�4�������E>��d�զV�Y]2ƒ�B|�ÝC:�'�lA���.�9>��V��>�W�wW�#�Խ+�X��D���Q����䣍JD�e�'�o'�tG�Eؠ�Ep������{/C.l(ʠi���������;�֊�;N_�c�~㉌n ۓo�>��Cg;��)8!? ���2j�E�7�s���z�{/������E�p̐��CZ�a��;�E�����pFO�U>�m�@#i~���Y^T��s�3�Ǻ���`��R��T��2.�c�kv�0w�� ��}���._7'�毛���1D�c$a����-U��[*/����2�q����O��? You are about to begin the application for the Home Energy Assistance Program (HEAP) Please refer to the video instructions below before proceeding with the application. The Percentage of Income Payment Plan Plus (PIPP) is an extended payment plan in which customers pay a percentage of their income toward their utility bill each month. L�vm�S�&���&��� 2620 0 obj <> endobj English. Home Energy Assistance Program (HEAP) Procedures Please read and acknowledge by signing below: The HEAP program is a once a year utility bill assistance program (only I bill per year, per household). ,K �������HRg'62�2�@��N�%��̤�=��Fj�ن�Պ[����V�߭���s�QFk������������������F��4������͗.�~z�����]���|ܬ�l?������a���yٳ���~����~�v��~�_��_>q��Ks�rQq�����(X�����ͻ������~����y��R���q�v*�g������W�oZ�O/��r(/O����3]?m�f��~�a�ѷ!�#��z]4��қ/�n�_����.�9�՛��w����ǎӇ��|��w����gM���=���$*�I~ze���8�UT�=�ǧ���/� The Home Energy Assistance Program (HEAP) provides one-time financial assistance to help balance an eligible household's utility bill. If you do not submit the required documents in a PDF file - your application will NOT be processed. You will have to begin the application process all over again. %PDF-1.6 %���� Program (HEAP), and emergency HEAP provide the benefit directly to a customer’s utility bill. 2627 0 obj <>/Filter/FlateDecode/ID[<22DB7A781BA6664F978B1798BC91F065><3342178739525E46B21011E36A59D35A>]/Index[2620 21]/Info 2619 0 R/Length 56/Prev 523721/Root 2621 0 R/Size 2641/Type/XRef/W[1 2 1]>>stream ��6�pi0��Z��d�0�q�=nv Name (Include Last, First Middle Initial) Date of Birth. LDSS-3421 (Rev. 2020 APPLICATION FOR THE LOW-INCOME HOME ENERGY ASSISTANCE PROGRAM (LIHEAP) Coronavirus Recovery Crisis Program. New York City residents can mail their application to: HRA/HEAP, PO Box 1401, Church Street Station, New York, NY 10008 Please note: The above processes are for Regular HEAP benefits only . h��[]���ݟҏ{5��@`�7{����׈�O��@��d�Ɍ1#��߽U�:j59-�$��"|P�#6Y�.~4Y����;:ӻΧ�l濹#�}G��.���>w��D�t�v��)t�u���W|g2��h`}!v�x×R�zb�!q���� �MǶ�d�E��y�E'$�.z&^�&���(ij� �͑k�Ds"�%ќ�2I4g�]͙�X�a�]b�|��a�uH�ِM]b�Ʋ���p����8:�}g|O]&!|w�5�`]�Es�9�h�l=��d9�hN|;Y4g�;͑T�pGR�1cS��;bG2c�d ���93/,H �z�@�H�$,H>��Kk ��#6;����ތ�23��������r�L� �>bf��~�Mb���%��q�b�Z�A$������Y���ÌƐ���m����4��Fpl��F��1$6���b#���;��bC|+5c�W��s=ߗ�1�΍�ԜTX�|l��5e�̸-�cRfl�)�ޑ0nN�̼�މ����!