The Nevada Energy Assistance form is a crucial document designed to help eligible households in Nevada manage their heating and electric costs. By completing this form, families can access financial support to ease their energy bills, ensuring they stay warm in winter and cool in summer. If you believe you qualify, please fill out the form by clicking the button below.
IMPORTANT NOTICE
How to Apply for the Energy Assistance Program (EAP)
Submit a completed application (to include the name, date of birth and Social Security Numbers for EVERY PERSON who lives in your home) with the following verification:
1.Proof of identity for the head of household (such as a driver’s license, government issued I.D., school I.D., etc.) and;
2.Proof of citizenship or legal status if born outside of the United States and;
3. Proof of where you live:
a.Provide a complete copy of your rental/lease agreement (listing all persons
in your home) and the signature page, or
b.a copy of your mortgage statement and;
7/21
4.Provide a copy of most recent heating/cooling bills and;
5.When the utility bill is not in the applicant’s name, proof of identity for the individual listed on the utility bill is required along with written authorization for
the applicant to apply, that includes their address, phone number and signature
and;
6.Proof of ALL income for EVERY PERSON in the household for at least the last thirty (30) days.
Examples of types of income: Employment, child support, social security, Veterans benefits, retirement, public assistance, utility reimbursements, unemployment insurance, interest income, money from family and/or friends, or organizations, educational scholarships and/or grants, etc.
Note: If the employed individual is working through an employment agency, provide proof of the last 12 months of earned income.
7.If the household expenses exceed the household income, proof of how the household is meeting their needs.
**FAILURE TO PROVIDE THIS INFORMATION MAY DELAY THE
PROCESSING OF YOUR APPLICATION. **
Prior year recipients may not reapply until approximately 11 months after they
received their last benefit.
Applications are processed in the order in which they are received. Applicants will receive a notice of decision once an eligibility determination has been made.
Please mail or fax your application and verifications to:
Energy Assistance Program
2527 N. Carson St., #260
3330 E. Flamingo Rd., #55
Carson City, NV 89706
Las Vegas, NV 89121
Fax: (775) 684-0740
Fax: (702) 486-1441
Division of Welfare and Supportive Services
ENERGY ASSISTANCE APPLICATION
The Energy Assistance Program (EAP) is designed to help eligible Nevada households with their annual heating and electric costs.
INCOME REQUIREMENTS
The total gross monthly income of all household members may not exceed the amounts shown in the chart below.
YOUR HOUSEHOLD’S GROSS MONTHLY INCOME MAY NOT EXCEED:
Persons in
Annual
Monthly
Home
Income
1
$19,320
$1,610
2
$26,130
$2,177.50
3
$32,940
$2,745
4
$39,750
$3,312.50
5
$46,560
$3,880
6
$53,370
$4,447.50
7
$60,180
$5,015
8
$66,990
$5,582.50
(For families/households with more than 8 persons, add $6,810 for each additional person).
Households with a chronic or long-term illness, who pay out of pocket medical expenses and whose gross income exceeds the income guidelines, may have their countable income reduced by verified qualifying expenses.
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BENEFITS
Eligible households receive an annual one-time per year benefit called a “fixed annual credit” customarily paid directly to their energy provider(s). The benefit shows as a
credit on the bill.
MINIMUM PAYMENT –The minimum yearly payment for eligible households is $240.
WHEN TO APPLY
If your family is not currently on the program and you meet the income requirements, apply NOW.
If you received a benefit during the past 12 months, a notice will be mailed to you when it is time to reapply. If you submit an application prior to the date you’re eligible to reapply, the application will be denied.
WHAT DO I NEED?
Submit a completed an EAP application with the required documentation. Suggested income verifications are noted on the back of this page. To get answers to other questions, call:
Reno/Carson City
(775) 684-0730
Las Vegas
(702) 486-1404
Toll Free
(800) 992-0900
Visit our website at: http://dwss.nv.gov for more information on the program requirements.
You can find information about the Weatherization Assistance Program at:
http://housing.nv.gov/programs/Weatherization/
DOCUMENTATION EXAMPLES OF REQUIRED PROOF OF INCOME
All documentation sent with your application can be either originals or photocopies. If you are unable to photocopy the originals, our office will copy the material and if requested, we will send it back after your case has been processed.
Earned Income: Includes income from employment, self-employment (see below), child care services, house cleaning, and any service for which you are paid. Provide copies of check stubs (if paid in cash, a statement from the person who paid you for a service) for at least the last thirty (30) consecutive days. If paid weekly – 4 check stubs; paid bi-weekly or semi-monthly – 2 check stubs. If you do not have check stubs, a signed and dated statement of letterhead from your employer stating your gross income for the last thirty
(30)days and how often your get paid, is acceptable. If working through an employment agency or on-call provide proof of the last 12 months of income.
Self-Employment/Non-Profit Business Income: May include profit and loss statements signed by the applicant detailing gross income and expenses (receipts must be provided for deductions) during the last 12 months, a copy of the sales tax statement showing gross net proceeds, financial statements, a loan application listing income and expenses for the last 12 months, or DWSS Form 2011 that includes receipts for allowable deductions. Allowable deductions include: cost of goods sold, supplies and materials, advertising, accounting and legal fees, wages paid to employees, office space rent/mortgage, telephone, utilities, transportation costs necessary to produce income, etc.
(Page B) 2824 – EL (7/21)
Unearned Income: Includes income from Social Security Administration, Veterans Administration, pensions, disability, military service, unemployment, child support, alimony, interest, dividends, regular insurance or annuity payments. If you are receiving
Social Security, SSI, Veterans Benefits, pensions, disability income, military income or unemployment: provide copies of the benefit verification form or award letter for the current year showing any cost of living raises. If you are receiving child support/alimony income: provide a copy of divorce decree/separation/settlement agreement or dated letter from the person paying the support (to include name, address and phone number), or a copy of the last check/statement from the child support enforcement agency. If you are receiving interest income/dividends: provide 12 months of bank
account statements, certificates of deposit or other documentation that contains details and is signed by the financial institution, or a broker’s quarterly statement showing earnings.
Cash Contributions and/ or Recurring Gifts: If someone is helping you pay your
expenses or is giving you money: provide a signed statement from each person that includes their name, address, phone number, if the assistance will continue, and the amount provided to you during the last six months. Provide a signed and dated statement by the person providing the money indicating the amount of support, how often it is paid,
when the arrangement began, and whether it is paid directly to a vendor or in cash to you. The statement must include the contributor’s printed name, address(es), and phone
number(s).
Student Income: Includes ALL scholarships and grants, e.g., Pell Grant, Federal Supplemental Educational Opportunity Grant (FSEOG), Veterans Administration
educational benefits. Please provide written confirmation of the amount of assistance, and the educational institution’s written confirmation of the cost for the prior two (2) semesters and summer school (if applicable) of the student’s tuition, fees, books and equipment. If
benefits are paid directly to the student, copies of the latest benefit checks or canceled checks or receipts for tuition, fees, books, and equipment are acceptable.
Public Assistance Income: Includes but is not limited to TANF, county general assistance, Clark County Social Services, or American Indian/Alaska Native General Assistance. Provide a written statement from the public agency with the amount paid during the last month, or a copy of the award letter or check.
PLEASE NOTE: 1099 and W-2 forms by themselves are not acceptable as proof
of income.
DIVISION OF WELFARE AND SUPPORTIVE SERVICES
ENERGY ASSISTANCE PROGRAM
MAIL OR FAX OUR APPLICATION TO ONE OF THE OFFICES LISTED BELOW OR EMAIL YOUR APPLICATION TO: ENERGYASSISTANCE@DWSS.NV.GOV
LAS VEGAS / NORTH LAS VEGAS 3330 E. Flamingo Rd., #55
Telephone: (702) 486-1404
OFFICE FOR ALL OTHER AREAS
2527 N. Carson Street, Suite 260,
Telephone: (775) 684-0730
APPLICATION FOR ASSISTANCE
Please complete every section and answer each question. Sign the application and the Rights and Obligations form. Failure to complete all sections and questions and/or sign the application and Rights and Obligations, OR provide the requested documentation noted on the application, will delay processing your application and may result in your application being denied.
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A. APPLICANT/HOUSEHOLD INFORMATION
Complete the following for every person living in your home, including yourself (attach additional page if necessary). The first name on the application should be the applicant (person listed on the utility bill in the home). Provide proof of identity for the applicant.
U.S.
S
Citizen or
E
Eligible
Name
X
Date of
A
*Non-
Social
(Last, First, Middle)
Relationship
M/
Birth
G
citizen
Disabled
Security
(Jr., Sr., III)
to You
F
(mm/dd/yy)
Yes No
Number
SELF
Are there additional people in your home?
YES
NO
If “YES,” list them on a separate sheet of paper.
Home Address (include apartment or unit number)
City
State
Zip
Mailing Address (If different from your home address.)
(Page 2 of 21) 2824 – EL (7/21)
Once you have gathered all necessary documents, you are ready to complete the Nevada Energy Assistance form. This process involves providing accurate information about your household and submitting required verifications. Follow these steps carefully to ensure your application is processed without delays.
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What is the Energy Assistance Program (EAP) in Nevada?
The Energy Assistance Program (EAP) is a state initiative designed to support eligible households in Nevada with their heating and electric costs. The program provides a one-time annual benefit, known as a "fixed annual credit," which is typically paid directly to the energy provider. This benefit helps reduce the financial burden of energy expenses for qualifying families.
What documentation is required to apply for the EAP?
To apply for the Energy Assistance Program, you must submit a completed application along with several forms of verification. This includes proof of identity for the head of household, proof of citizenship or legal status, documentation of residence (such as a rental agreement or mortgage statement), recent heating and cooling bills, and proof of income for all household members. If the utility bill is not in the applicant's name, additional documentation is required. It is crucial to provide all necessary information to avoid delays in processing.
What are the income eligibility requirements for the EAP?
The total gross monthly income of all household members must not exceed specific thresholds, which vary based on the number of people in the household. For example, a household of one cannot exceed $1,610 per month, while a household of four must remain under $3,312.50. If a household has a long-term illness and incurs out-of-pocket medical expenses, they may qualify for a reduction in their countable income. This provision can assist families who are close to the income limits.
How can I submit my application for the EAP?
You can submit your completed application and required documentation by mailing or faxing it to the appropriate Energy Assistance Program office. The addresses for the Carson City and Las Vegas offices are provided in the application materials. Ensure that all documents are included to facilitate a smooth application process. If you have questions or need assistance, you can contact the program's offices directly or visit their website for more information.
Incomplete Personal Information: Failing to provide the name, date of birth, and Social Security Numbers for every person living in the household can lead to delays. Each individual must be accounted for in the application.
Missing Proof of Identity: Not including proof of identity for the head of household is a common mistake. Acceptable documents include a driver’s license or a government-issued ID.
Omitting Proof of Citizenship: If anyone in the household was born outside the United States, proof of citizenship or legal status must be provided. Forgetting this step can result in application denial.
Insufficient Proof of Residence: Applicants often neglect to include a complete rental or lease agreement or mortgage statement. Both documents must clearly show where the household resides.
Utility Bill Issues: If the utility bill is not in the applicant's name, proof of identity for the person listed on the bill is necessary. This includes written authorization for the applicant to apply.
Failure to Document Income: It is essential to provide proof of all income for every household member for the last thirty days. Missing this documentation can hinder the application process.
Ignoring Household Expenses: If household expenses exceed income, applicants must show proof of how they are managing their needs. This information is crucial for eligibility.
Not Following Submission Guidelines: Applications must be mailed or faxed to the correct addresses. Sending them to the wrong location can cause unnecessary delays.
Reapplying Too Soon: Prior year recipients must wait approximately 11 months after receiving their last benefit to reapply. Submitting an application too early will lead to denial.
The Nevada Energy Assistance form is an essential document for households seeking help with their heating and cooling costs. Along with this form, applicants often need to provide additional documents to ensure a smooth application process. Below is a list of other forms and documents that are commonly required.
Providing all necessary documents can significantly reduce delays in processing the application. It is crucial to ensure that each document is complete and accurate to facilitate a timely response from the Energy Assistance Program.