LIHEAP FASTRACK APPLICATION INSTRUCTIONS,
SUBMISSION & PROCESS GUIDELINES
All applicants must be a resident of Jackson County in order to be considered for utility assistance. You are required to complete an online or a mail in application. Submitting an application does not guarantee service. Once application is completed, the system will generate an application number and this is your confirmation of having successfully submitted the application online. Due to the processing of applications, it can take up to 45 days to process. Since processing an application takes time, client should be patient and refrain from submitting another one while the first one is being processed.
Submit the following legible (readable), required documents pertaining to your household within 15 working days from time of application submission:
Our agency has in no way any intent to deny services for individuals who meet the eligibility criteria: Elderly- 60 years old and older; Disabled; Household with children 5 years old and under; Households who has energy assistance need. It is the Applicant’s responsibility to provide legible documentation within 15 days from date of application to process application for assistance.
|“Effective October 1, 2018 amended 07-03-2022 firstname.lastname@example.org|
Jackson County Senior Citizens LIHEAP Obligation Policy
Graceville Office 263-2774 or 263-4650; Marianna Office 482-5028 or 482-4914
Our agency has in no way any intent to deny services for individuals who meet the eligibility criteria: Elderly- 60 years old and older; Disabled;Household with children 5 years old and under; Households who has energy assistance need. It is the Applicant’s responsibility to provide legible documentation to process application for assistance.
1. MANDATORY: the “applicant” provide identity that he/she live in this county: acceptable forms of proof, Florida’s driver license (must
be valid, and cannot be pass the expiration date), permanent Florida ID, current work or current School ID card with address; Military ID with address. No out of state identification will be accepted.
2. Provide copy of the original utility bill. Electric bill needs to show average annual home energy usage in kilowatt-hours, an average annual home energy cost; Propane/Gas/Fuel Oil statement needs to show size of tank and current % in tank.
3. On all pre-paid accounts, have at least 14 calendar days of energy service on the account.
4. A copy of all Household total grossed Income for the last 30 days must be reported in one of the following ways: 1. Wages. 2. Self-employment (most recent form of IRS tax forms, quarterly tax records, W2 or 1099) 3. Social Security. 4. SSI. 5. Child Support. 6. Regular Monetary Gifts with amount. 7. Unemployment Compensation. 8. Retirement. 9. Temporary Cash Assistance (TANF) 10. Pension (state, federal, VA, etc) 11. Regular monetary assistance from family/friend who has not received assistance from our program. 12. Rental Income. 13. School related benefits. Electronic proof is acceptable. If you are the applicant, and do not work, a written statement is required. Ages 16-17 and do not attend school, a written statement is required why you do not work and/or attend school. NO BANK STATEMENTS.
5. If child (ren) do not received any income, please provide documentation that you have cooperated with necessary authority to receive income on their behalf. Individual who is over the age of 18 years of age and does not work has to complete a no-income form or write statement as to why they do not work.
6. Birth Certificate/Hospital Birth Record for children 5 years old and younger.
7. Current Food Stamps Benefits: Statement from Dept. of Children & Families, electronic Access Florida statement; statement must consist of amount, household members on lease/rental agreement and the month you are requesting utility assistance.
8. Provide one form of documentation of disability: DMV statement, DMV decal, physician’s statement, and/or listed on proof of income.
9. Copy of Social Security Card for each member of household.
10. Alien Status: provide necessary governmental documentations of legality for residing in Jackson County and country.
11. Provide legible typed and/or written statement if your utility bill is in someone else’s name, the reason needs to be in writing.
12. New Services: provide a copy of current paid house/apartment rent deposit receipt, work order form from utility company, copy of a signed lease/rental/family property agreement.
13. Disconnected services: a copy of current paid house/apartment rent receipt, a signed lease/rental agreement, and a written statement from property owner that you will remain in the home for an additional 30 days.
14. Homeowners, provide a copy of ownership for your place of resident. If you live on/in family home/property, provide written statement from executor of estate that you have permission to live in that dwelling.
If mortgage is currently in foreclosure, provide valid documentation that you will remain in the home at least 30 days from the date of application.
15. Renters: 1. provide a copy of signed lease or rental agreement that shows: your utility reimbursements and/or utility allowances. 2. Provide calculation page showing how rent is figured for subsidy. 3. Household members listed. 4. Documentation cannot be more than a year old.
5. Signed lease/rental agreement by Landlord/property owner and the applicant.
16. Family property: If you the applicant name is not listed on deed, a statement from family member listed on deed has to put in writing that you have permission to live in the home.
1. This process can take up to 45 days. You are responsible to continue paying on your energy account until application has been processed.
2. SSA & SSI benefits: http://www.socialsecurity.gov/onlineservices
3. Food Stamps: http://www.myflorida.com/accessflorida
4. Child Support: http://floridarevenue.com/dor/childsupport/
APPLICATION CAN BE SUBMITTED ONLINE AT: jacksonseniors.org clicking on the tab “FASTRACK”
READ, SIGN, AND SUBMIT FRAUD POLICY:
- Fraud occurs when an Applicant knowingly and willingly provides false information about their circumstances in order to receive assistance. Fraud also occurs when an Applicant intentionally fails to report changes in household circumstances in a timely manner. Fraud is considered theft and a crime therefore the Agency should report the criminal activity to their local law enforcement agency. The information provided to apply for the LIHEAP program is to be true and complete. It is agency to provide needed energy assistance to households with the lowest income and greatest need, i.e., those households in-which the elderly, disabled, or children resides. If it has been determined that you the applicant or any member of your household has deliberately and willfully provided false information to receive assistance from the LIHEAP program, your application will be denied.
- Responsibility of Agency: This agency will report the criminal activity to the local law enforcement agency. Full cooperation will be given to legal agencies involved with cases.
Intentionally withholding information.
- Household composition at time of requesting assistance; people who claim household members or list household members that do not actually reside in household regardless if they are children or adults.
- Gross Income from all sources, people who do not report all income whether earned or unearned
- County of residents
- Submitting rental or lease agreement of someone landlord and making up a fictitious tenancy.
- If, it is determined or appears that false information was provided during the application process, the file is denied and the client is notified in writing.
- People who do not declare all income whether earned or unearned
- People who claim household members or list household members that do not actually reside in household (example-children).
Applying for assistance in the future
At a minimum, any Applicant and/or Client who commits fraud is ineligible to apply for LIHEAP services for a period of 2 years after the discovery of the fraudulent actions. This restriction applies to anyone living in the household at the time the fraud was committed and is requesting services for the same household.
INVESTIGATION AND PROSECUTION
- Fraud is considered theft and a crime therefore the Agency should report the criminal activity to their local law enforcement agency.
- Once every attempt has been made to contact and work with the client for recovery of overpayments and the client has been unresponsive or uncooperative, the information should be turned over to local law enforcement.
- The Agency should continue to work with the prosecuting officials, and the Agency can, if requested, receive and track repayments from the client.
- All repayments must be returned to DEO.
- The Agency must contact DEO and keep staff informed as to the progress of the investigation, the disposition, and if any funds will be returned.
I ___________________________________ acknowledge that I have received the Fraud Policy from the Jackson County Senior Citizens.
Applicant’s Telephone # (______)___________________
LIHEAP Office Regulations
No money, cash, or checks will be requested or received from consumer/applicant in a Liheap Office. If an employee asks for money, report to the Agency’s Director/Liheap Coordinator. If for any reason your application is denied, a written notice stating the reason will be mailed to you. If this action is incorrect, you have the right to request a hearing or send a written appeal to this agency at address below or call 850-263-4650 or 850-263-2774 within 10 working days after receipt of the notice of denial letter. All appeals will be conducted during normal business hours of the Jackson County Senior Citizens Org., Inc. We have the right to respond within 10 working days. If you still object to the decision, you have the right to appeal to the Executive Director within 5 working days. The Executive Director has 10 working days to respond and must clearly state that the decision is final and if applicable, the circumstances in which the applicant may reapply for services. Appeals Address:
Carolyn D. Rhynes, Executive Director
5400 Cliff Street
Graceville, FL 32440
Applicant’s Signature Date
Completed Application Process Policy-Updated 7-7-22
During the application process, in which can take up to 45 days, an applicant( the person who has submitted application for energy assistance), should not to contact this agency regarding the status of their application. Once application is processed a letter of approval or denial will be mailed to applicant. Submitting an application does not guarantee service.
- ALL DOCUMENTATION SUBMITTED ACCORDING TO LIHEAP INFORMATION LIST BY THIS AGENCY.
- Online applications will be processed
- APPLICATIONS ARE PROCESSED IN OUR GRACEVILLE OFFICE. IF THE APPLICANT HAS APPLIED IN THE MARIANNA OFFICE, THE APPLICATION IS THEN SENT TO THE GRACEVILLE OFFICE FOR PROCESSING. IF THE APPLICANT HAS APPLIED AT THE GRACEVILLE OFFICE, THEN YOUR APPLICATION WILL BE PROCESSED IN LIKE MANNER.
- APPLICATION IS REVIEWED BY GRACEVILLE STAFF, TO ENSURE YOU SUBMITTED ALL NECESSARY DOCUMENTATION
- IF IT IS FOUND THAT ALL INFORMATION HAS NOT BEEN SUBMITTED, A LETTER IS SENT IN GIVING YOU 14 WORKING DAYS TO PROVIDE THE INFORMATION
- AN AUTHORIZATION FOR RELEASE OF GENERAL INFORMATION IS FAX OR EMAILED TO YOUR UTILITY COMPANY.
- UPON RECEIVING INFORMATION BACK, YOUR APPLICATION WILL BE WORKED UP WITHIN 15 WORKING DAYS OF THE APPLICATION DATE. THIS IS BASED ON THE RECEIPT OF INFORMATION FROM UTILITY COMPANY
- IF APPROVED, AN APPROVAL VOUCHER LETTER WILL BE EMAILED OR FAXED TO YOUR UTILITY COMPANY
- UNTIL YOUR ACCOUNT HAS BEEN CREDITED WITH PAYMENT, YOU ARE RESPONSIBLE TO CONTINUE PAYING ON YOUR ENERGY ACCOUNT.
- REMEMBER THIS PROCESS CAN TAKE UP TO 45 DAYS.
INSTRUCTION TO SUBMIT LEGIABLE COPIES FOR ASSISTANCE
|For Health and Safety reasons, no one will be allowed in office to complete a LIHEAP application for utility assistance. We highly recommend you to please follow one of the procedures to submit current COPIES of documents pertaining to your household to apply for LIHEAP utility assistance.|
I. By Mail:
Jackson County Senior Citizens Jackson County Senior Citizens
5400 Cliff Street 2931 Optimist Drive
Graceville, FL 32440 Marianna, FL 32448
II. By Email:
III. Drop Off:
In a sealed envelope with name and phone number in drop box or office
Areas surrounding Graceville: 5400 Cliff St-Graceville
Areas surrounding Marianna: 2931 Optimist Dr-Marianna
Mail Drop slot: Monday-Friday
An application can be completed on website: jacksonseniors.org
V. Alternate application completion:
By phone once ALL necessary documents has been submitted.
Friendly reminder, the process for assistance does not start until ALL requested documents have been submitted. If you have any questions, call
Graceville Office Area Marianna Office Area