Application for Financial Help to Heat or Cool Your Home

Low Income Home Energy Assistance Program (LIHEAP)

How to apply for LIHEAP

  1. Fill out the attached application. Answer every question. If your application is not complete, it will be delayed or returned.

  2. Send your completed application and documents to the LIHEAP agency in the county you live in. You can find your LIHEAP agency on the back of this page.

When to apply for LIHEAP - Energy Assistance (EA)

  • Send your application on or after October 1, 2024 if: Any member of your household is age 60 or over, or if any household member is disabled.
  • Send your application on or after November 1, 2024 if: Your household doesn’t include a person age 60 or over, or who is disabled.
  • The last day to apply for EA is May 31, 2025.

When to apply for LIHEAP - Energy Crisis Intervention Program (ECIP)

  • You can apply for Winter ECIP from November 1, 2024 to May 31, 2025 for elderly/disabled households, and December 1, 2024 to May 31, 2025 for all other households.
  • All households can apply for Summer ECIP from June 1, 2025 to September 30, 2025.
  • ECIP requires the household to provide a disconnect notice for energy payments.

How to apply for ECIP (Crisis)

  • If you have not received EA for this year, you must complete the entire application.
  • If you received EA from October 1, 2024 to May 31, 2025, and there are no changes you do not need to complete a new application, contact your local agency.

After you send your application

The LIHEAP agency will review your application:

  • You will receive notification of approval, denial, or requests for additional information from the Family Support Division.

Important:

  • Continue to make utility payments to your utility company.
  • Benefits are dependent on available funding.
  • 1 bill + 1 meter = 1 Household

Where to send your LIHEAP Application

Search for your local office by referring to the county in which you live.

Audrain, Boone, Callaway, Cole, Cooper, Howard, Moniteau, Osage

Central Missouri Community Action (CMCA)

800 N Providence Rd Ste 200

Columbia, MO 65203-4300

Phone number: (573) 443-1100 Fax (573) 370-1212


Website: https://cmca.us/get-help/energy-assistance/

Jefferson, Franklin

Jefferson-Franklin Community Action Corporation (JFCAC)

PO Box 920

Hillsboro, MO 63050-0920

Phone number: (636) 789-2686 Fax (636) 789-2866

www.jfcac.org

St. Louis County

Community Action Agency of St. Louis County (CAASTLC)

2709 Woodson Rd

Overland, MO 63114-4817

Phone number: (314) 446-4420 Fax (314) 446-4480

Camden, Crawford, Gasconade, Laclede, Maries, Miller,

Phelps, Pulaski

Missouri Ozarks Community Action, Inc. (MOCA)

PO Box 69

Richland, MO 65556-0069

Phone number: (573) 765-3263 Fax (573) 232-1638

Andrew, Buchanan, Clinton, DeKalb

Community Action Partnership of Greater St. Joseph

(CAPSTJOE)

1322 N. 36th St.

St. Joseph, MO 64506

Phone number: (816) 233-8281 Fax (816) 233-8262

IVR: (816) 693-6868

Carroll, Chariton, Johnson, Lafayette, Pettis, Ray, Saline

Missouri Valley Community Action Agency (MVCAA)

1415 S Odell Ave

Marshall, MO 65340-3144

Phone number: (660) 542-0418 Fax (660) 831-5039

Atchison, Gentry, Holt, Nodaway, Worth

Community Services, Inc. of Northwest Missouri (CSI)

PO Box 328

Maryville, MO 64468-0328

Phone number: (660) 582-3113 Fax (660) 582-2965

Lewis, Lincoln, Macon, Marion, Monroe, Montgomery,

Pike, Ralls, Randolph, Shelby, St. Charles, Warren

Northeast Community Action Corporation (NECAC)

815 Business Highway 61 N

Bowling Green, MO 63334-1351

PPhone number: (573) 324-0120 Fax (573) 213-4858

Barton, Jasper, Newton, McDonald

Economic Security Corporation of Southwest Area (ESC)

PO Box 207

Joplin, MO 64802-0207

Phone number: (417) 781-0352 Fax (417) 781-2011

Adair, Clark, Knox, Schuyler, Scotland

Community Action Partnership Northeast Missouri

(CAPNEMO)

PO Box 966

Kirksville, MO 63501-0966

Phone number: (660) 665-9855 Fax (660) 665-6557

Email: LIHEAP@campnemo.org

Bollinger, Cape Girardeau, Iron, Madison, Perry,

St. Francois, Ste. Genevieve, Washington

East Missouri Action Agency (EMAA)

PO Box 308

Park Hills, MO 63601-0308

Phone number: (573) 431-0103 Fax (573) 431-7377

Douglas, Howell, Oregon, Ozark, Texas, Wright

Ozark Action, Inc. (OAI)

710 E Main St

West Plains, MO 65775-3307

Phone number: (417) 256-6147 Fax (417) 256-0333

Dunklin, Mississippi, New Madrid, Pemiscot, Scott,

Stoddard

Delta Area Economic Opportunity Corporation (DAEOC)

99 Skyview Rd

Portageville, MO 63873-9180

Phone number: (573) 379-3851 Fax (573) 379-9139

Barry, Christian, Dade, Dallas, Greene, Lawrence, Polk,

Stone, Taney, Webster

Ozarks Area Community Action Corporation (OACAC)

215 S Barnes Ave

Springfield, MO 65802-2204

Phone number: (417) 864-3460 Fax (417) 864-3472

Caldwell, Daviess, Grundy, Harrison, Linn, Livingston,

Mercer, Putnam, Sullivan

Green Hills Community Action Agency (GHCAA)

1506 Oklahoma Ave

Trenton, MO 64683-2587

Phone number: (660) 359-3907 Fax (660) 359-2038

Butler, Carter, Dent, Reynolds, Ripley, Shannon, Wayne

South Central Missouri Community Action Agency (SCMCAA)

PO Box 6

Winona, MO 65588-0006

Phone number: (800) 325-4633 or (573) 325-4255

Fax (573) 325-4543

City of St. Louis, Wellston

Urban League (ULSTL)

1408 N. Kingshighway Blvd.

St. Louis, MO 63113

Phone number: (314) 615-3632 Fax (314) 615-3632

Jackson, Clay, Platte

Mid America Assistance Coalition (MAAC)

4001 Dr. Martin Luther King JR. DR., Suite 270

Kansas City, MO 64130-2350

Phone number: (816) 768-8900 Fax (816) 768-8901

Bates, Benton, Cass, Cedar, Henry, Hickory, Morgan, St. Clair, Vernon

West Central Missouri Community Action Agency (WCMCAA)

112 W 4th Street

Appleton City, MO 64724-1402

Phone number: (660) 476-2185 Fax (660) 476-5901

Part 1 - Enter Contact Information

Office: {Office}

Address: {Address}

City State Zip: {CityStateZip}

Phone Number: {PhoneNumber}

If you have problems uploading any of your attachments, please send email to {Email}

For additional household members

Part 3 - Enter Utility Information
  • Indicate in the “Fuel Source For My Home” section below, DSS will only pay EA benefits for the fuel type selected under this section.

If you have a disconnect notice, send it with this application.

Part 3 - Enter Additional Utility Information
  • If you or someone in your household suffers from a life threatening medical condition, send a medical statement from a qualified doctor or nurse. The statement should indicate the household member has a life-threatening medical condition, but does not have to state a diagnosis or condition.
Part 4 - Enter Information if You Don’t Pay the Utility Company Directly
Part 5 - Enter Household Income

If anyone in your household has income from a job or self-employment:

  • Fill in this section to show all income anyone gets from tips, payments for service, and wages for all jobs, even if someone has more than one job. If you need to list additional income, provide it on a separate sheet of paper.
  • Send copies of documents that shows all gross income received by anyone last month, such as paystubs. Gross income is income received before taxes are withheld. If anyone was employed in the last six (6) months but did not receive income from that job last month, provide proof of final wages earned and last date worked from that employer.

List everyone in your home age 18 or older who received income from a job last month. (Include all jobs.)

If yes, send a copy of the most recent Federal Income Tax Form 1040, including Schedule 1, 
for each self-employed person along with your application.

Part 6 - Enter Court Ordered Child Support (if applicable)

Court-ordered Child Support that is paid to someone outside your household can be deducted so that it doesn’t count as income. To receive this deduction, fill in your 8-digit Child Support case number below.

Part 7 - Enter Other Income
  • Send copies of documents showing income anyone received last month. If you need to list additional income for any household members, send a separate sheet of paper with the information.
Social Security
Supplemental Security Income (SSI)
Temporary Assistance for Needy 
Families (TANF)
Supplemental Aid to the Blind (SAB)
Blind Pension (BP)
Supplemental State Payments (SSP)
Foster Care
Alimony
Child Support
Part 7 - Enter Other Income Continued
Unemployment Compensation
Veterans Benefits
Pensions
Railroad Retirement
Rent Received from Land or Buildings
Money Received from Friends, Family,
or Organizations
Armed Forces Allotment
Union Funds or Strike Benefits
Worker’s Compensation or Temporary Private Disability
Other Unearned Income
Part 8 - Enter Resource Information - Split this for household members.

If anyone in your household has savings or other accounts, fill in the total amounts of money everyone has in each type of account.

Checking: Single and/or Joint Accounts

Stocks/Bonds and Mutual Funds

IRA/KEOGH and/or Deferred Compensation Plans

Savings: Single and/or Joint Accounts

CDs, Annuities, and/or Money Markets

Part 9 - Notice That You Can Get A Fair Hearing - For Informational Purposes Only

As an applicant for the Low Income Home Energy Assistance Program (LIHEAP), you may request a hearing for the 
following reasons:

1)     If your LIHEAP application is denied.


2)     If your LIHEAP application is not reviewed timely.

A request for a hearing can be made in writing, by phone, by fax, or in-person.

Documents you must send with your application to avoid processing delays (send copies, originals will not be returned):

Papers you need to send if any member of your household got any income last month:

Part 10 - Your Consent For The LIHEAP Agency To Process (Review) This Application

Read the Consent for Processing in the box below and sign. If you do not sign and date the application, your LIHEAP application will not be processed.

I hereby apply for assistance under the LIHEAP laws of the State of Missouri administered by the Department of Social Services (DSS). I declare that the information I have given is true, correct, and complete to the best of my knowledge. I realize that the information which I have given on this application will need to be verified by the LIHEAP agency.

If any household member declared on my application is currently receiving SNAP, TANF, or Child Support, I hereby authorize the LIHEAP agency to use my Family Support Division (FSD) file to see if we qualify for LIHEAP. I hereby authorize the LIHEAP agency, FSD, and my fuel supplier to provide to one another any of my customer, application and account information (such as: service address, energy source, customer account number, past due amount, notice of disconnection, etc.) to determine my eligibility and to otherwise administer the program. to determine my eligibility and to otherwise administer the program. I give permission to DSS to use information provided on this form for purposes of research, evaluation, and analysis of the program.

I understand that I may be fined, imprisoned, or both under state or federal law if I make false statements on this application in order to get benefits I am not entitled to receive.

    Thank you for submitting your application for the Low Income Home Energy Assistance Program (LIHEAP).  Below you will find information on how long it might take to process your application.  If you have any questions or would like a status update, please contact your local LIHEAP agency.

    LIHEAP agencies:

    https://dss.mo.gov/fsd/energy-assistance/pdf/liheap-contracted-agencies.pdf

    Your Form ID is: {formuniqueid}.

    Processing Timeline:

    LIHEAP Application Timeline: Day 1 LIHEAP is received, Day 3 LIHEAP Application is registered in system, Day 30 LIHEAP Application is fully processed within 30 days, Day 31 Listing is made for pledge approval, Day 45 Supplier responds with approve or denail of pledge, Day 60 if approved will send payment to supplier if approved within 15 calendar days.