Fax your completed application to Drop Off or Mail your completed application to:. Good Samaritan Network. Fishers, IN Call to request an application be mailed to you.
Local Service Agencies LSA , like Good Samaritan Network, may take 55 days to determine if you are eligible, and it may take an additional 30 days for the utility company to process your benefit.
Winter Assistance Program. An Energy Assistance Program recipient is protected from having their regulated utility disconnected between December 1 and March Instead, contact your trustee office for immediate assistance. Processing applications may take 55 days to determine if you are eligible after November 1 , and it may take an additional 30 days for the utility company to process your benefit. You will receive a letter in the mail or by email advising you of your benefit.
Eligible Activities and Funding. This program provides assistance through a fixed benefit amount for the cost of the primary source of heat which includes, but is not limited to:. Payments for actual usage or fuel delivery are made directly to the heating vendor for primary energy needs from November 1 thru May 16 - except when the cost of heating is included in the rent.
Eligibility and Timeline Details. There are a variety of factors that impact the eligibility of a household. Eligibility determination is based on three months of income. Monthly Income and Annual Income listings are reference only. You may receive Energy Assistance if your income does not exceed the below income limits.
See below for a detailed breakdown of income qualifications. You can also contact the National Energy Assistance Referral Hotline at , if you need help figuring out what is available in your community. There may be other programs operated by your local LIHEAP office, utility company, or other charities to help you pay your energy bill.
Required Information - No Exceptions. It should also be listed on the front of the application. Photo ID for the person completing and signing the application. Proof of SSN for each member of the household. This may be:. Current documentation of income for all household members age 18 or over. This may include:. Request for Earnings information form — contact GSN.
Most recent award letter may be downloaded from online. Most recent Form tax return, with all appropriate self-employment schedules. Unemployment Benefits. Completed release of information form for DWD. Full print-out of your most current Uplink statement. Any documentation of payments received. If you heat with bulk deliverable fuel, provide most recent delivery receipt. If utilities are included in your rent, please provide a completed Landlord Affidavit.
If you have any questions about acceptable documentation, contact your local service provider. Depending on household circumstances, additional documentation may be required. Please contact your local service provider with any additional questions.
Disconnect Note. Again, after November 1st, if you are about to be disconnected or are already disconnected, you are advised to contact your Good Samaritan Network for an appointment rather than applying online. A mail-in application may take too long to process to prevent being disconnected! Please call and make an appointment. What other kinds of Utility Assistance is available? If you are seeking additional assistance with utilities, or need help more quickly than EAP is able to provide, please apply for EAP, then look into the following resources:.
Indiana Partnership. Salvation Army. Catholic Charities. Water assistance is now available through the Water Assistance Program. Review the information needed, write the application information clearly, sign your application and provide copied documents with the application.
Then email, fax, drop off or mail the application. See below for a detailed breakdown of income qualifications. You can apply for an energy assistance benefit for Program Year from October 1, until May 16, Benefit notifications to applicants and vendors begin.
In-person appointments begin. Appointments are not required to apply—you can submit your application electronically, via email or mail your application. Energy moratorium begins. Eligible EAP clients cannot be disconnected from electricity and heating service. The Moratorium law Indiana Code states that from December 1st through March 15th of any year, a regulated utility company may not turn off residential utility service to any customer who is eligible for and who has applied for the Energy Assistance Program.
This includes utilities that are electric or gas, including municipally owned, privately owned, or cooperatively owned utilities. Moratorium protection applies once a household submits an application and allows the Local Service Provider time to determine eligibility, so please inform your utility provider if you have submitted an application for assistance and you are scheduled for disconnection.
Local Service Agencies may take 55 days to determine if you are eligible, and after your benefit has been awarded it may take an additional 30 days for the utility company to process your benefit. Please continue to pay your utility bills while waiting for your EAP benefit to appear on your account. If you are receiving a direct pay benefit, it may take up to days, or four months, from the date of your benefit approval for your payment to be processed and mailed to you.
Please do not follow up on your benefit if days has not passed yet. If you feel you have been wrongly denied, or that your benefit amount was calculated incorrectly you may file an appeal. You must send your appeal to the Local Service Provider within thirty 30 days of receipt of the denial.
The Local Service Agency will review your appeal and send you a written response within fourteen 14 calendar days. Please send your formal appeal to:. To apply for EAP, please contact your local service provider via the map on this page or apply online here. This will direct you to the EAP online application. If you are about to be disconnected or are already disconnected, you are advised to contact your local service provider for an appointment rather than applying online. Please click here to access the EAP online application.
If you are at risk of disconnection, please do not mail your application! A mail-in application may take too long to process to prevent being disconnected. Please call and make an appointment with your local service provider, call or submit an online application and indicate that you are in crisis. If you are seeking additional assistance with utilities, or need help more quickly than EAP is able to provide, please apply for EAP, then look into the following resources:.
Salvation Army. Water assistance is now available through the Water Assistance Program.
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