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Documents required
to apply

Application 2025

Anyone over the age of 18 in your household with no income

Zero Income Form

Self-Employment Form

This form must be filled out by a doctor before you can apply for LIHEAP if you are disabled and not receiving financial assistance due to your disability.  

Verification of 
Disability Form

GRIEVANCE PROCEDURES

Este formulario debe ser completado por un médico antes de que pueda solicitar LIHEAP si usted tiene una discapacidad y no recibe asistencia financiera debido a su discapacidad.

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