LIHEAP Forms
The following forms are available for LIHEAP applicants to download. Please contact our office at 508-588-5440 if you have related questions.
- Fiscal Year 2021 LIHEAP Application Addendum
- Fiscal Year 2021 Child Support/Alimony Documentation Form
- Fiscal Year 2021 Low-Income / No Income Form
- Fiscal Year 2021 No Income (Zero Income) Statement
- Fiscal Year 2021 Proxy Authorization Form
- Fiscal Year 2021 New Utility Account Number / New Oil Dealer
Due to the COVID-19 Pandemic all notary requirements have been waived until further notice for the following two forms. Please refer back to our website for future program updates.