The federally funded Low Income Home Energy Program (known as Fuel Assistance Program) provides certified eligible households with assistance in paying their energy bills during the winter season. Households where elderly, disabled persons and/or children under the age of 6 reside can apply for assistance beginning in July. All other households may apply beginning September 1, 2017. Fuel assistance season ends April 30, 2018.
Benefits are calculated on a number of things, including household income, energy costs, and housing type. This allows those households with the lowest incomes and highest energy costs to receive the highest benefits. Applications are taken through our Community Services Offices in Dover and Farmington. Please note: Households can also apply for and receive electrical assistance at the same appointment, if eligible.
Fuel Assistance Forms
- Landlord Form
- Self-Declaration of No/Low Income Form
- Employment Release Form
- Child Support Verification Form
- IRS 4506-T Form (verification of non-filing)
- Change of Address or Vendor
Required Document Checklist
Please use this checklist to be sure that you have included all of your documentation. Incomplete applications will not be eligible to receive a benefit and will be denied; call our office to find out how to reapply if you application has been denied.
Income: Gross wages for all household members for the last 30 days prior to your application date.
- 5 pay stubs if paid weekly
- 3 pay stubs if paid bi-weekly
- 2 pay stubs if paid monthly
Examples of required income: Employment, Pensions, Retirement, Civil Service , Unemployment, Worker’s Compensations, Bank Interest over $50 for year, Self-employment, Annuities, Alimony, Any income received by Social Security Administration, etc.
Child Support Paid Out or Received: A child support form must be completed for households where both biological parents do not reside. If you pay out, provide proof of receipts within application income period.
State and City Assistance: If you have received assistance from your local town welfare or Department of Health and Human Service (Food Stamps, TANF, APTD, OAA, FAP, NHEP, etc.) you will need a copy of the most recent decision letter.
Proof of Residency: Homeowners: will need to provide a copy of mortgage statement or property tax bill. Renters: Your landlord will need to complete a Landlord/Tenant Verification Form
No or Low Income: Anyone 16 years or older with no or low income, who is not in high school, must complete a No/Low Income Form. Assistance Form may be requested if help is received outside of the home.
Self-Employed: Any household member that is self-employed is required to provide a copy of their SIGNED current tax return along with the Schedule C and all supporting schedules.
Current Tax Return: All applicants must provide a copy of their complete IRS Tax Return. Any adult household members that did not file will need to complete IRS form 4506-T to confirm non-filing.
Social Security Cards and Date of Births: for all household members, if applicable.
Fuel Vendor/Account Number and Usage:Vendor must be established before your application date. If you have used the same fuel vendor for the past 12 month, please provide 12 months of fuel costs.
Electric Bill: most recent electric bill (Eversource or NH Electric Co-op)
Please keep in mind that not all circumstances can be addressed and that additional paperwork may be requested during the application process.
Please feel free to contact our office at 603-435-2500 to discuss unusual circumstances so we can best assist you.
New Hampshire Electronic Application System (to apply for cash or child care assistance, Medicaid, food stamps and Medicare Savings)