Quick
Search
go >
Intake
Forms
Definitions
Search
References
Administration
Site Map
print this page
Forms
2016 LIHEAP Detailed State Plan
(.pdf)
2016 Contract - Specific and General Terms & Conditions
(.pdf)
2017 LIHEAP Household Information Form;
pg 1
(.pdf)
2017 LIHEAP Household Information Form; pg 2
(.pdf)
2017 LIHEAP Spanish Household Information Form;
pg 1
(.pdf)
2017 LIHEAP Spanish Household Information Form; pg 2
(.pdf)
2016 Two Advances/One Reimbursement Voucher Spreadsheet
(.
xls)
2017 Back-up Heat Cost
(.pdf)
2017 Actual and Surrogate Heat Costs
(.pdf)
2017 Roomer Boarder Heat Costs
(.pdf)
2017 EAP Income Guidelines
(.pdf)
2016 LIHEAP Constants and Adjusters
(.pdf)
2016 PSE Constants and Adjusters
(.pdf)
2016 LIHEAP Upload File Specifications
(.pdf)
2016 PSE Upload File Specifications
(.pdf)
Exhibit 1.1.1 (A): Ten Day Notice
(.pdf)
Exhibit 1.1.1 (B): Household Income Information Form
(.pdf)
Exhibit 1.1.1 (C): Employer Earned Income Form
(.pdf)
Exhibit 1.1.1 (D): Declaration of No Income
(.pdf)
Exhibit 1.1.1 (E): Visual Documentation Form
(.pdf)
Exhibit 1.1.1 (F): OES/Owner Release Form
(.pdf)
Exhibit 1.1.1 (G): Client Self-Dec Income Form
(.pdf)
Exhibit 1.2.2 (A): 2016 Actual And Surrogate Heat Cost
(.doc)
Exhibit 1.2.2 (B): 2016 Back-Up Heat Cost
(.doc)
Exhibit 1.2.2 (C): 2016 Roomer And Boarder Heat Cost
(.doc)
Exhibit 1.3.1 (A): Self Employment Income Worksheet
(.pdf)
Exhibit 1.3.1 (A): Self Employment Income Worksheet
(.xls)
Exhibit 1.3.1 (B): Rental Property Income Worksheet
(.pdf)
Exhibit 1.3.1 (B): Rental Property Income Worksheet
(.xls)
Exhibit 1.4.1 (A): Example Invitation To Bid
(.pdf)
Exhibit 2.2.0 (A): Proof of Residence (.pdf)
Exhibit 4.1.2 (A): Client Education Checklist
(.pdf)
Exhibit 4.1.2 (B): Family Guide To Energy Efficiency
(.pdf)
Exhibit 4.1.2 (C): Can We Help Template
(.pdf)
Exhibit 4.1.2 (D): Conservation Education Certificate
(.pdf)
Exhibit 4.1.2 (E): Conservation Education Follow-up Form
(.pdf)
Exhibit 4.8.0 (A): Fair Hearing Request Form
(.pdf)
DSHS BVS Non-Disclosure Form
(.doc)
Employment Security-Earnings Deduction Chart
(.pdf)
UCC1 Financing Statement Form
(.pdf)
SSA Verification Sheet
(.pdf)
Need
Adobe Acrobat Reader
?
Contact Us
|
Site Map
|
Choose Pages To Print
|
Home