Application Packets

Note: A completed application packet with supporting documents is required to apply for all programs.

 

All Programs Application Packet

Complete this packet to apply for one program, or all three programs at the same time:
HEAP, Weatherization and Water Assistance.

• LIHEAP Application Packet (PY 2026)
• LIHEAP Application Packet Spanish (PY 2026)

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Water Tips and Other Programs

• Water Conservation Tips
• California Water Boards assistance program

 

 

Application Replacement Forms

Note: These forms are to be used individually as needed. To apply for services, you must complete and
submit an application packet and supporting documentation.

 

HEAP and Weatherization Forms

• CSD-43 Energy Intake Form (English)
• CSD-43 Energy Intake Form (Spanish)
• CSD-600 Statement of Citizenship or Non-Citizen Status for Public Benefits Rev-3-24-06
• CSD-600 Statement of Citizenship or Non-Citizen Status for Public Benefits Rev-3-24-06 (Spanish)
• CSD-81 Consent Form English
• CSD-81 Consent Form Spanish
• 2025 Acknowledgment Form ( English and Spanish )
• CSD-43B Certification of Income and Expenses - ENGLISH
• CSD-43B Certification of Income and Expenses - SPANISH
• LIHEAP Statement of Financial Support 5.0 (Bilingual)
• Application Referral Source
• PG&E CARE Online Enrollment
• Home Energy Conservation Tips
• Make a Budget Worksheet
• CSD-51 SWEATS Intake Form (For use only during declared extreme weather conditions)

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Weatherization Forms

• Weatherization Intake Form
• Weatherization Intake Form - Spanish
• CSD-515A Energy Serv Agreement - Occupant-2-12-16392
• CSD-515B Energy Serv Agreement - Prop-Owner-2-12-16798

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Other Forms

• Service Referral and Follow-Up Summary
• SOC341--Report Elder Abuse Form
• SOC342--Report Abuse for Financial Institutions
• Community Center Rental Application
• Household Facts Sheet