energy assistance

Forms

Documents you can download are listed below:

Avista Release    Gives SNAP permission to electronically access Avista account when account holder is not a primary applicant.
DSHS Information Release    This document allows SNAP to access your basic income and household information in the Washington Department of Social and Health Services (DSHS) database.
Employer Income Release    Form for Employer to complete to verify income. Used when there is missing or no paystubs available.
Household Member and Income Information Form    This is the primary application document for the Low Income Home Energy Assistance Program (LIHEAP) and the Washington State Household Energy Assistance Program (SHEAP).
Self Declaration and Zero Income Statement    To declare income that you are unable to prove or to declare that you have zero income
Vera Release of Information    Only use if Vera Water and Power is your electricity provider.