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Northcentral Arkansas Development Council, Inc. (NADC) has contracted with the Arkansas Department of Environmental Quality for local administration of the 2023 Low-Income Home Energy Assistance Summer Program. The Regular and Crisis Assistance Program will begin July 10, 2023, and run through September 29, 2023 or until funds are depleted, whichever occurs first. We will be helping with electric as well as all other heating/cooling sources.

The following requirements are needed before applications can be processed:

  • Proof of all income for all household members for the previous month.
  • Copy of the upper portion of electric bill and propane/gas bill. (BOTH BILLS ARE REQUIRED)
  • Proof of identification
  • Social Security Cards for all household members.
  • If your household was a zero-income household for the previous month, other documentation will be required.

ARKANSAS LIHEAP
Application for Utility Bill Assistance

Complete all sections and attach requested documentation; failure to do so will delay eligibility determination.

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Please select your county.
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Splitting a regular benefit will not result in a larger benefit amount.
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APPLICANT - PLEASE PUT YOUR NAME AND INFORMATION HERE

attach a copy of ID(e.g. driver's license) and Social Security Card

Please enter your last name.
Please enter your first name.
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Please enter your mailing address.
Please enter your city.
Please select your state.
Please enter your ZIP code.
Please select: yes or no.

Please enter your mailing address.
Please enter your city.
Please select your state.
Please enter your ZIP code.

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OTHER HOUSEHOLD MEMBERS - DO NOT INCLUDE YOURSELF

Please list the other persons living in your household but not yourself. Please provide all of the information for each individual.

Household Member 1
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Household Member 2
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Household Member 3
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Household Member 4
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Household Member 5
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Household Member 6
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Household Member 7
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Household Member 8
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Household Member 9
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HOUSEHOLD INCOME

WORK INCOME - List anyone in your household (18 and older) who has work income (includes self‐employment, babysittng, and other odd jobs). List additional information on a separate sheet, if necessary. ATTACH PROOF OF INCOME.


Employeed Household Member 1
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Employeed Household Member 2
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Employeed Household Member 3
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B. LAST EMPLOYMENT - If you or any adult (18 or older) member of your household is unemployed at the time of this application, list the most recent employment below.


Unemployed Household Member 1
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Unemployed Household Member 2
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Unemployed Household Member 3
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C. NON-WORK INCOME - List anyone in your household who receives any of the following and attach proof of this income:
Alimony | Child Support | Housing Utility Assistance Payment | Retirement Benefits | Social Security Income (SSA) | Supplemental Security Income (SSI) | Supplemental Security Disability Income (SSDI) | TEA | Unemployment Benefits | Veteran's Benefits | Worker's Compensation | Any other non-work income


Household Member 1
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Household Member 2
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Household Member 3
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D. RESOURCES - Does anyone in your home have any of the following?


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Stock / Bond details
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Other Resources (list)
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CRISIS APPLICANTS ONLY:

If your household is in need of crisis assistance, please indicate below:

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UTILITY/RENT INFORMATION

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Please enter the amount you pay for rent.
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HOME ENERGY SUPPLIER INFORMATION

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SECONDARY HEATING SUPPLIER IS OPTIONAL, COMPLETE ONLY IF YOU WANT ASSISTANCE WITH THIS BILL.
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VERIFICATION OF IDENTITY (ID)

You must attach proof of identity. Acceptable proof includes A READABLE COPY of any VALID document that reasonably establishes identity such as:

  • Arkansas Driver's License
  • Voter registration card
  • A recent paycheck stub
  • Federal, state, or local government issued ID
  • ID card for health benefits or other assistance
  • U.S. Military Card or dependant's card
  • Work or school ID card with photograph
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WEATHERIZATION SERVICES (WAP)

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APPLICANT'S RIGHTS AND RESPONSIBILITIES

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LOW INCOME HOME ENERGY ASSISTANCE PROGRAM

This federally funded program is contracted through the Arkansas Department of Environmental Quality to provide assistance to low income individuals and families to help with Heating and Cooling bills.

LIHEAP Contacts

Name Position Phone Number
Tracey Sherman Fulton County Coordinator 870-895-3628
Rita Cude Independence County Coordinator 870-793-2561
Leneil Taylor Stone County Coordinator 870-269-4381
Shirl Harris Izard County Coordinator 870-368-4329
Becky Campos Sharp County Coordinator 870-994-7353

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