Please have the following ready:

1. Utility bill account number and mailing address as shown on monthly bill
2. Date and amount of previous energy assistance received within the last 12 months
3. Social Security number plus identity verification (driver’s license, state ID, etc.) and date of birth for each household member
4. Pay amount and employer’s name for each employed member of the household
5. Amount of unearned income received by each member of the household (Social Security benefits, pension/retirement benefits, veteran’s benefits, military allotments, DHS FIP cash assistance, Supplemental Security Income (SSI), Workers’ Compensation, child support, etc.)
6. Monthly and annual income last year for each self-employed person
7. Bank account statements
8. Vehicle registration

An old couple sitting on a bench and a bike beside them

Requirements

If you are a Detroit senior (age 60+) who is experiencing financial hardships and unable to meet your basic daily needs (food, housing, utilities, medicine, clothing, etc.), you’re eligible to complete this form.