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Please provide the following documents with your application. Failure to
provide any of the documents could keep you from receiving assistance:

• A completed Application (all forms) (LIHEAP requirement)
• A copy of a current Texas photo ID for every household member age 18 and over (LIHEAP requirement)
• A copy of the Social Security card (or document showing number) for every member living in the home (TDHCA)
• Food Stamps Benefit Statement (LIHEAP requirement)
• A copy of the most recent utility bills for heating or cooling the home – electric, natural gas, LP gas (LIHEAP)
• A 12‐month billing history of your energy usage from each utility company providing service to you (CSNT requirement)
Utility companies may fax history to 903‐665‐9845
Utility companies may email histories to history@csnthelp.org
Utility bill MUST be either:
‐ in a household member’s name
‐ in a landlord’s name with a c/o sign to a household member

• Proof of income for the most recent 30 days (Examples: Check stubs, current Social Security
Administration Benefit Letter for all beneficiaries in the household, DHS/TANF statement,
payment listing for Unemployment Benefits, any proof of receiving payments for work) (LIHEAP requirement)
• Declaration of Income Statement (DIS Form) (TDHCA requirement)

Citizenship / Immigration and Naturalization Forms
Please provide one of the following:
• A copy of a valid US passport for everyone in the household who has one (TDHCA requirement)
• A copy of the birth certificate of everyone living in the household who has one (TDHCA requirement)
• A copy of the Green Card for every person in the household who has one (TDHCA requirement)
• A copy of the Naturalization Certificate for everyone in the household who has one (TDHCA requirement)
• A copy of the Voter ID / Registration Card for every person in the household who has one (TDHCA requirement)
and
• A signed SAVE Certification Form (TDHCA requirement)

Make sure you have:
Completed FORM 579 and FORM 545; Sign page 3 of the FORM 575 (CSNT requirement)
Signed FORM 702 if you are disabled and Signed FORM 705 if you have no proof of income (TDHCA requirement)
Signed FORM 711 and Signed CEAP Training Verification (CSNT requirement)
Signed SAVE Certification Form and provided proper Citizenship documents
Selected the proper mailing address from the back page