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SOUTHINGTON COMMUNITY SERVICES

Please call our office at 860-628-3761 to schedule an appointment.


APPLICATION:
Click here to print an application form. Complete the form and bring it in with you when you apply for Energy Assistance.

If anyone in your household receives any of the following benefits your entire household is categorically eligible for the CT Energy Assistance Program (CEAP):

  •  Temporary Family Assistance (TFA)
  •  State Supplement Income
  •  Supplemental Nutritional Assistance Program (SNAP)
  •  Refugee Cash
  •  Supplemental Security Income (SSI)
You must provide a copy of the applicable benefit letter. You must also provide a copy of a recent electric bill, regardless of your heating source/fuel.

Proof of income for all members of the household 18 years and older (if you do not receive any of the benefits listed above): 
INCOME:
You will need proof of all sources of income and proof of no income from all members in the household 18 years and older. Examples of proof of income and no income:
Employment:
  • Last 4 consecutive pay-stubs (if paid weekly)
  • Last 2 consecutive pay-stubs (if paid biweekly or bi-monthly)

Self Employment:
You will need the Self-employment forms that are available in our office or click here to print the form. You must fill it out prior to your appointment. The information needed for this form is the last 6 months or 12 months income and expenses of your business. It must be notarized.
You will also need a copy of your last year’s Tax Return.

Social Security for Current Year:
Either a copy of check or stub, last months bank statement showing direct deposit, or a TPQY printout.

Pension
Either a copy of your pension benefit letter(s) or your most recent 1099 form. 

Unemployment:
• Printout from unemployment showing the amount paid in the last 4 weeks.

Workers Compensation:
Letter stating the amount received or a copy of the last four (4) checks

Child Support/Alimony:

Either a copy of the divorce decree stating amount paid (weekly, monthly, etc.), a quarterly report, check stubs, bank statement (if direct deposited), or a written letter from the person who pays support to you

If you are not receiving child support payments, complete the affidavit certifying non-receipt of child support payments, available here.

Friends or Relatives Support Form:
A signed statement from a family member or friend who gives you money. It must state how much and how often. The form must be notarized. Click here for Friends or Relatives Support Form.

Rental Income:
Multi-family homeowner must show all rental income with any of the following:
  • Copy of a recent check,
  • Copy of rent-stub(s), OR
  • Lease agreement 

Zero Income:
Any household members 18 or older must complete a zero income form (click here to print a form) and state how they have been living for the past four (4) weeks without any income.

IF YOU DO NOT HAVE ALL THE HOUSEHOLD INCOME, WE WILL HAVE TO RESCHEDULE YOUR APPOINTMENT.

PROOF OF PRIMARY SOURCE OF HEAT:
For oil heat you must have the name of your oil vendor and make sure they are participating in the program before your appointment.

For gas you must have your current Eversource Gas and Eversource electric bills. The bills must be in the name of a family member age 18 or older who resides in the home and must be charged to your current address.

For electric you must have your current Eversource electric bill. The bill must be in the name of a family member age 18 or older who resides in the home and must be charged to your current address.


YOU WILL NEED COPIES OF THE FOLLOWING:
Proof of all stocks, CDs, Bonds, and IRA’s (IRA’s if you are 59 ½ or older)

Rent Receipt and Lease (only if heat is included in the rent)

YOU WILL NEED TO KNOW THE FOLLOWING INFORMATION:
Social Security numbers for everyone in the household

Dates of birth for all family members