Forms

This page contains a variety of helpful resources and commonly used forms. Download and review these forms before contacting us.

*************The Online Application Portal (CALIHEAP) is temporarily unavailable. You may download and complete the application below and submit by:*******************

E-Mail: heap@sjgov.org

Fax: 209-932-2649

US Mail: Energy Program, PO Box 201056, Stockton CA 95201

Self Service Drop Box: 333 E. Washington Street, Stockton CA 95202

 

Low Income Home Energy Assistance Program Online Application

 

APPLICATION PACKETS (NOTE: Required to apply for all programs)

Low Income Home Energy Assistance Program (LIHEAP) Application (Complete this application to apply for HEAP and Weatherization, or all three programs together: HEAP, Weatherization, and Water Assistance.)

Low Income Home Water Assistance Program (LIHWAP) Application (Complete this application to apply for Water Assistance only.)

 

APPLICATION REPLACEMENT FORMS (NOTE: To be used individually as needed. To apply for services, you must complete an application packet.)

HEAP and Weatherization Forms

Weatherization Forms

Water Assistance Forms

Other Forms

 

 

 

 

 

 

 

 

 

 

 

Helpful Numbers

Child Abuse Hotline

(209) 468-1333

Elder Abuse

(209) 468-3780 or
(888) 800-4800

Fraud Hotline

(209) 953-7733