All client intake appointments can be done over the phone or in-office. You can schedule your intake appointment on-line OR by calling 508-588-5440.
We are now open at our new location at 780 West Main Street, Avon.
Fill Out Your Application Online or Book and Appointment Here
Other important operational information:
- First Time/New applicants can now ALSO APPLY on-line.
- After Intake Appointment, please make sure to mail/drop/fax signed and completed application and all requested documents. Please return your signed application to us ASAP to: Self Help Inc. Home Energy Assistance, 780 West Main Street, Avon, MA 02322
- Mail Drop Box is now available at our 780 West Main Street, Avon office.
- If You have Questions – you can either call us at 508-588-5440 to speak with an Information Specialist, or check the status of your application through our 24/7 automated phone system. Simply call 508-588-5440 and choose option for 24 hour automated system and follow the voice prompts.
- You can also Fax Information to 508-300-9548 (please note this is NOT the preferred method as docs can sometimes be unreadable)
- Copy services are not available until further notice.
- DO NOT EMAIL documents to our office. For data security reasons we are unable to accept emailed documents.
- Due to the HIGH Volume of Applications and paperwork, we are not able to call each client to confirm we received their application/documents. Please call 508-588-5440 to speak to an information Specialist or to use our automated system.
What Information Do I Need to Provide When I Apply for Home Energy Assistance?
Documentation required for your Home Energy Assistance Program Application
Below is a list of the required documentation you will need for your Home Energy Assistance Program application, piease review and click the “More Details” links for information about each type of documentation required.
- Picture Identification for the person who applies.+ More Details
More Information
A new applicant must provide picture identification when applying to the program. One of the following documents may be used:
- Valid Driver’s License or State I.D. Card
- Student Identification Card
- U.S. Military Card
- Valid United States Passport
- Current USCIS (formerly known as INS) Employment Authorization Card *
- Current Foreign Passport with Attached Employment Authorization *
- Certificate of U.S. Citizenship
- Certification of Naturalization *
- Permanent Resident Card (Green Card)
- MBTA Senior Identification/Transportation Access pass (TAP) with picture
- Employee Identification Card with picture
*Additional information will be required to document Qualified Alien Status, see Qualified Alien Status.
- Citizenship or Qualified Alien Status for household members.+ More Details
More Information
A new applicant must document citizenship and/or qualified alien status for all members of the household when applying to the program. One of the following documents may be used for Identification and Citizenship purposes:
- US Birth Certificate (State or territory – from USA, District of Columbia, Puerto Rico, Guam, US Virgin Islands, American Samoa, Swain’s Islands, or Norther Mariana Islands.
- Valid US Passport
- Report or Certification of Birth Abroad of a U.S. Citizen
CITIZENSHIP: The following may be used for Citizenship purposes (Partial List):
- SSA issued Social Security card – must have all 9 digits
- SSA issued Medicare Card– must have all 9 digits of SSN. Newly issued Medicare Cards without your SSN cannot be used for Citizenship documentation.
- SSA issued Proof/Receipt of application for SSN – good for first year ONLY
- Certificate of Naturalization (n-550 or N-570)
- Certificate of Citizenship (N-560 or N-561)
- Certification of Birth Abroad of a US Citizen (Form FS-240, FS-545 or DS-1350)
- INS Form I-551 (Permanent Residence Card, valid Conditional/Permanent Residence Card, Alien Registration Card = Green card)
- Temporary I-551 – unexpired
- Asylum and Refugee documents
QUALFIEID ALIEN STATUS: The following may be used for documenting Qualified Alien status (Partial List)
- INS Form I-551 (Permanent Residence Card, valid Conditional/Permanent Residence Card, Alien Registration Card = Green card)
- Temporary I-551 – unexpired
- Asylum and Refugee documents
- Proof of income for everyone in your household 18 years or older for the past 30 days. If someone is 18 years or older and a full-time student, bring a letter from their school/college. + More Details
More Information
All required documentation must be returned to Self Help with your signed application.
- Child Support: Copy of court order, DOR printout (call 1.800.332.2733) and request a payment history, copies of support checks for the past 4 weeks or a notarized statement from support source.
- Employment: Copy of the four most recent paystubs (stubs must have name or SS# on them) or a letter from employer stating your gross wages for the last 4 weeks or gross annual wages (with date of hire) accompanied by one paystub. Note: Documents must be for the 4 weeks prior to application return.
- Financial Support: Download the Financial Support form here.
- Foster Care/Adoption: Printout from DSS or letter from source stating the gross amount and frequency.
- Social Security/SSDI/SSI Copy of current award letter or 1099: To get a printout call 1.800.772.1213. Checks and bank statements ARE NOT acceptable for proof of social security income, just SSI.
- Pension, Veterans: Pensions must reflect “GROSS” amount – please submit check stub, letter from source or recent 1099. Veterans may also provide letter from Veterans Agent.
- Unemployment: Submit a printout showing your last 4 weeks of benefits – NOT the Determination of Benefits letter. A printout is needed if you are working to verify what you receive unemployment benefits along with paystubs for the same time period. All printouts must include your name and/or the last 4 digits of your SSN.
- Workers’ Compensation: Copy of current stub which shows gross amount, date of loss and dates the check stub covers. If your stub doesn’t have the date of loss, please submit the last 4 consecutive stubs or a letter from the lawyer, insurance company or employer stating the above information.
- Interest/Dividend: Copy of the current 1099 or letter from bank stating interest or dividend amount for either one month or the entire year prior to application date.
- Rental Income: Most recent Form 1040 with all schedules. 1040 needs to be signed by you and the tax preparer. If it is self prepared, it must ne notarized, and you will need to request the transcript form 4506-T. You can obtain this form online by visiting IRS.gov and select “get a Transcript” or call 1-800-908-9946. If a tax return is not filed, rent receipts for one month or tenant letter stating amount of rent and frequency along with copies of recent tax bill, homeowners insurance, water and sewer bill and interest on the mortgage.
- Self Employed: Copy of current signed tax form (1040 & Schedule C) along with all other schedules. If it is self prepared, it must be signed and notarized, and you will also need to request the transcript form 4506-T. You can obtain this form online by visiting IRS.gov and select “get a Transcript” or call 1-800-908-9946. For any other household members who may have income, please refer to this list for specific documents needed to reflect last 4 weeks of income.
- Odd Jobs: Contact our office for a form and instructions 508.588.5440 or download the Odd Jobs form here.
- Students: Students (18 years and older) must submit a current letter from school specifying status (full time or part time). If working, submit wage documents plus the school letter.
- Other Income/Lump Sum: 1099s and tax forms may be required. Includes, but not limited to: royalties, cash/lottery prizes, financial aid, trust and/or estate income, inheritances, capital gains, income derived from sale of stocks/bonds, scholarships, regular insurance payments, stipends/fellowships and housing allowance. Lump sum income is counted once during a 12-month period.
- For renters, a recent copy of your lease, or for homeowners, your mortgage statement and/or property tax or homeowners bills.
- Your most recent primary heating bill and electric bill. + More Details
More Information
A list of all primary heating sources allowed under the program:
- Oil
- Natural Gas
- Electric
- Propane
- Heat Included in your rent
- Coal
- Kerosene
- Wood
- Corn