Tip for State/local-specific

LIHEAP income limits are typically 150% of the federal poverty level or 60% of the state median income — whichever is higher

Tip for State/local-specific

Ask about Crisis Assistance if you have a disconnect notice or are out of fuel — emergency help may be available faster

Tip for State/local-specific

You can also apply for weatherization assistance to reduce future energy costs

Housing & Social Needsmoderate

LIHEAP Application

State/local-specific · State LIHEAP agencies / Community Action Agencies

Application for Low Income Home Energy Assistance Program. Helps pay heating/cooling bills or emergency energy costs. Priority for elderly (60+), disabled, and households with children under 6.

Form Details

Total fields: 45
Auto-fillable: 30 (67%)
Time without BeneFill: 40 minutes
Time with BeneFill: 10 minutes
Time saved: 30 minutes
Filled by: patient
Frequency: annual
State-specific: Yes — form may vary by state

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Where to Submit This Form

🌐

Apply through your state or local LIHEAP agency

https://www.acf.hhs.gov/ocs/low-income-home-energy-assistance-program-liheap

Find your state LIHEAP office through the HHS directory. Some states accept online applications.

🏢

At your local Community Action Agency or LIHEAP office

https://www.acf.hhs.gov/ocs/map/liheap-map-state-and-territory-contact-listing

Find your local agency at the ACF LIHEAP directory.

📬

Mail to your local LIHEAP administering agency

Filing Deadline

Varies by state — most states accept applications during the heating season (October-March) and/or cooling season (May-September). Some states have year-round programs.

Required Attachments

📎 Proof of identity (photo ID, birth certificate)
📎 Proof of income for all household members (pay stubs, benefit letters, tax return)
📎 Most recent utility bill(s) or proof of home energy costs
📎 Proof of residency (lease, mortgage statement, utility bill in your name)
📎 Social Security numbers for all household members

Processing Time

Typically 2-4 weeks from receipt of a complete application. Emergency/crisis assistance may be available within 48 hours in some states.

What Happens Next

Your local agency will determine eligibility based on income and household size. If approved, payment is typically made directly to your utility company. You may also qualify for weatherization services.

Tips for This Form

✓ LIHEAP income limits are typically 150% of the federal poverty level or 60% of the state median income — whichever is higher
✓ Ask about Crisis Assistance if you have a disconnect notice or are out of fuel — emergency help may be available faster
✓ You can also apply for weatherization assistance to reduce future energy costs
✓ Households with elderly (60+), disabled, or young children (under 6) often receive priority

More Housing & Social Needs Forms

LIHEAP Disability Verification Form

State-specific · State LIHEAP agencies

Verification of disability status for LIHEAP applicants not currently receiving SSI/SSDI. Provider license information must be included.

Section 8 / Housing Choice Voucher Application

PHA-specific · Local Public Housing Authorities

Application for Section 8 Housing Choice Voucher program. Waitlist selection may include preferences for disabled, elderly, or veteran households.

HUD Reasonable Accommodation Request

PHA/landlord-specific · Local Public Housing Authorities / landlords

Request for reasonable accommodation under the Fair Housing Act for individuals with disabilities. May include ESA documentation, accessibility modifications, transfer requests, and policy exceptions.

ESA (Emotional Support Animal) Verification Letter

Provider-specific · Healthcare provider

Letter verifying disability-related need for an emotional support animal in HUD-assisted housing. Must come from a licensed mental health professional with direct knowledge of the individual's condition.

HUD Medical Expense Deduction Documentation

PHA-specific · Local Public Housing Authorities

Documentation of medical expenses for deduction from income in HUD-assisted housing rent calculation. Includes insurance premiums, prescriptions, medical equipment, and ongoing treatment costs.

State Home Modification Grant Application

State-specific · State housing / aging agencies

Application for state-funded home modification grants to improve accessibility for individuals with disabilities or elderly residents. Covers ramps, grab bars, widened doorways, and bathroom modifications.

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Disclaimer: BeneFill™ provides form-filling assistance and informational guidance only. It is not affiliated with, endorsed by, or sponsored by the State LIHEAP agencies / Community Action Agencies or any government agency. The information provided is for general informational purposes and does not constitute legal, medical, financial, or tax advice. Always verify form requirements and submission details directly with the issuing agency.