PROGRAM APPLICATION FORM

TO QUALIFY FOR THE VOUCHER YOU MUST:

• Be enrolled in our Residential Energy Discount Program
• Be under the maximum income guidelines below:

Family of 1: Monthly $3,120, Yearly $37,440

Family of 2: Monthly $3,565, Yearly $42,780

Family of 3: Monthly $4,010, Yearly $48,120

Family of 4: Monthly $4,455, Yearly $53,460

Family of 5: Monthly $4,815, Yearly $57,780

Family of 6: Monthly $5,170, Yearly $62,040

Family of 7: Monthly $5,525, Yearly $66,300

Family of 8: Monthly $5,885 Yearly $70,620