CEAP (Comprehensive Energy Assistance Program)&LIHWAP (Low Income Household Water Assistance Program) Intake Application
Unfortunately, since you do not live in Hays, Caldwell, or Blanco County, you are not eligible for our program. Please try your local utility assistance office.
REMINDER: INCOMPLETE APPLICATIONS WILL NOT BE ACCEPTED or PROCESSED!
- Once the application is received with ALL supporting documents, it will be processed in the order completed and by priority.- Until your application is processed, you are responsible for your utility bills and any late fees applied.- Once the application is processed, you will be notified if you qualify for assistance. This application is for screening purposes only and does not guarantee your eligibility to receive services.- If you qualify for assistance, you will be called and sent information.- An appointment can be scheduled with a Case Manager if needed.- NOTE: All assistance is subject to the availability of funds.REQUIRED DOCUMENTS: for all programs
1. COMPLETED Intake Application.2. Copy of Valid photo ID and Social Security card of ALL IN HOUSEHOLD. (example: Texas Driver’s License, ID, & SS)3. Proof of ALL income for the past 30 days for all household members 18 years and older, who work or receive assistance. (Social Security/SSI/VA award letter, check stubs, TANF letter, unemployment benefits, child support, etc.)NOTE: If any member of the household, 18 or over, is NOT receiving any income, you must complete the attached Declaration of Income Statement.
To obtain Energy Assistance or Household Water Assistance - additional needed information: 4. PROOF OF CITIZENSHIP and IDENTITY for ALL household members. If you need help, please contact us.
5. A 12 month billing history from each of your energy providers. (Electric, Natural Gas & Propane) To get this history, City of San Marcos customers should request an “Electric Usage History” for Community Action, Inc. PEC customers should request a “Customer Profile.” City of Lockhart and City of Luling customers are required to pay a small fee for the report. Note: If a 12 month history is not available, please submit as many months available.6. Your current utility bills for Electricity, Natural Gas & Propane and a disconnect notice, if applicable.
To APPLY for 2022:
Applications can be mailed, emailed, faxed or delivered to the following locations:
Hays County & Blanco County:PO Box 748 San Marcos, TX 78667 or 215 S. Reimer Ave. Ste.130, San Marcos, TX, 78666512-392-1161, ext. 334 – Office Hours: 8am-12, 1-5pm Monday to FridayEmail: email@example.com Fax: 512-396-4255
Caldwell County:901 Bois D’Arc Street, Lockhart, TX 78644, 512-398-4420 (Please call for Office Hours)Email: firstname.lastname@example.org; Fax: 512-398-4189PO Box 231/109 E. Newton Street, Luling, TX 78648, 830-875-3707 (Please call for Office Hours)Email: email@example.com; Fax: 830-875-3706
CSBG Emergency Services and Case Management - determined on a case by case basis
CEAP Energy ASSISTANCE - about the programThe Comprehensive Energy Assistance Program (CEAP) combines education and financial assistance to help low-income consumers reduce their utility bills. Services include utility payment assistance for electric, natural gas and propane.Priority is also given to lowest percentages of income levels, highest energy burdens, vulnerable individuals 60 years and over, persons with disabilities, and families with children five years of age or under, and veterans.Utility Assistance Component (UA): Payments are to assist low-income households to reduce their home energy costs and payments up to allocation limits are based off the previous 12-month billing history. Low-income households with a vulnerable priority member receive assistance up to their allocation limit. Households with non-vulnerable member receive six months of assistance up to their allocation limit.Crisis Assistance Component (CAC): Provides Assistance with utility bills when households have lost service or are in danger of losing service and meet one of three conditions which include:1. Extreme Weather Conditions, 2. Declared Disaster, 3. Life threatening crisisPayments are made directly to the utility company and do not include any extra fees.
LIHWAP Water ASSISTANCE - about the programThe Low Income Household Water Assistance Program (LIHWAP) combines education and financial assistance to help low-income consumers in emergency situations in which they are: 1. behind in their bills and disconnection is threatened, OR 2. Consumers have been disconnected.Payments are made directly to the utility company and do include some fees.
Priority is also given to lowest percentages of income levels, highest energy burdens, vulnerable individuals 60 years and over, persons with disabilities, and families with children five years of age or under, and veterans.
REMINDER: INCOMPLETE APPLICATIONS WILL NOT BE ACCEPTED or PROCESSED!
‐ Once the application is received with ALL supporting documents, it will be processed in the order it is stamped complete and by priority. ‐ Until your application is processed, you are responsible for your utility bills and any late fees applied. ‐ Once the application is processed, you will be notified if you qualify for assistance. This application is for screening purposes only and does not guarantee your eligibility to receive services. ‐ If you qualify for assistance, you will be called and sent information. ‐ An appointment can be scheduled with a Case Manager if needed. ‐ NOTE: All assistance is subject to the availability of funds. SERVICE AREA The counties serviced by Community Services Block Grant (CSBG) and Comprehensive Utility Assistance Program (CEAP) include: Blanco, Caldwell, and Hays. FUNDING SOURCE This program is funded (in whole or in part) by the Texas Department of Housing and Community Affairs (TDHCA).
*VETERANS Please NOTE: Important Information for Former Military Services Members. Women and men who served in any branch of the United States Armed Forces, including Army, Navy, Marines, Coast Guard, Reserves or National Guard, may be eligible for additional benefits and services. For more information please visit the Texas Veterans Portal at https://veterans.portal.texas.gov/
FOR OFFICE USE ONLY: If there is a Conflict of Interest, this application requires the Executive Director's Signature.
OFFICE USE ONLY: CEAP/ LIHWAP/ CSBG ELIGIBILITY DETERMINATION
Calculations: Monthly x12 =
Monthly x12 = Total Annual Income $ Household Poverty Income Level: 0-50% >50-75% >75-125% >125-150% >150-200%Verification/Documentation of Household Income used: Staff Signature Date
AUTHORIZATIONS AND RELEASE OF INFORMATION:1. The information provided is true and correct to the best of my knowledge and belief.2. I understand that my gross household income is annualized at the time of application according to pre-established agency rulesand procedures in order to receive assistance.3. I understand that I may request a hearing to appeal a denial of eligibility, amount of assistance received, or a delay in receivingservices from Community Action, Inc. of Central Texas.4. I authorize the Texas Department of Housing and Community Action, Inc. of Central Texas to solicit/verify information includingemployment verification needed to provide assistance with my utilities and/ or fuel bills, both past and future.5. I am an applicant of Community Action, Inc. of Central Texas. I hereby give my permission to release and verify all informationrequested and understand that it will be kept in strict confidence to be used for program purposes only.I understand that photocopy of this release is as valid as the original and may be used to obtain employment information or verifyother data.6. I understand that if I change utility companies I must notify the case worker within 5 business days of my new utility companyand account number with the name on the account. If I do not notify Community Action, Inc. of Central Texas of my new utilitycompany I will lose any payments due. When the information is provided any remaining assistance may be reinstated.7. If I or another member of the household has no income the Declaration of No Income sheet must be completed for all householdmembers over 18 years of age having no income. Note: On this sheet do not include anyone who has shown income on theapplication. The Declaration of No Income no longer needs to be notarized.8. I UNDERSTAND THAT I AM SUBJECT TO PROSECUTION FOR PROVIDING FALSE OR FRAUDULENT INFORMATION ON THISAPPLICATION.
Systematic Alien Verification for Entitlements (SAVE) System and US Citizenship/US National Applicant Certification Form for CEAP, DOE‐WAP, LIHEAP‐WAP Subrecipients, and SHTF, ESG, HHSP, EH (political subdivision only) The program for which you are applying requires verification that you are a U.S. citizen, a non‐citizen national, or a legal resident of the United States. Documentation of your status is required. This agency uses the Systematic Alien Verification for Entitlements (SAVE) System to verify the status of non‐citizens.
Documentation of household income from all household members 18 years or older for the 30 day period prior to the date of this application must be uploaded prior to submitting the application.
State the gross income for household members, 18 years and older, who have no documentation of the income received in the 30 day period prior to the date of application for assistance:
Persons with Disabilities--Any individual who is:-A handicapped individual as defined in §7(9) of the Rehabilitation Act of 1973;-Under a disability as defined in §1614(a)(3)(A) or §223(d)(1) of the SocialSecurity Act or in V102(7) of the Developmental Disabilities Services andFacilities Construction Act: or-Receiving benefits under 38 U.S.C. Chapter 11 or 15.
APPLICANT’S AUTHORIZATION TO DECLARE DISABLED STATUS:I hereby confirm my eligibility as a Person with Disability, in accordance with the above-stated definition of Person with Disability.