I am a Homeowner or Tenant of the single-family home, manufactured home, or multi-family unit that will receive or have received energy efficient upgrades.
I am a customer of Orcas Power & Light Cooperative. I am aware that this utility and Community Action Agencies in my area can provide energy efficient upgrades at a high-level of assistance, but it requires I prove I meet certain income qualification guidelines.
I do hereby declare that my gross annual household income does not exceed the maximum income for my household size as indicated in the eligible income threshold above or as stated by my state or tribe.
OR
I benefit from any of the Eligible Income-Qualified Programs listed below.
• Section 8 eligibility
• LIHEAP certification
• HUD Housing
• Supplemental Social Security Income
• TANF
• NAHASDA
I certify that the information presented is true and accurate. I further understand false, misleading or incomplete information may render me (the Applicant) ineligible to receive my utility's higher income-qualified incentive. If my utility finds that any information provided in connection with this application is false, then my utility reserves the right to require reimbursement of any incentives provided to which I am not entitled. My utility reserves the right to request additional documentation or proof of income to verify income qualification and to verify benefits.
By selecting "Yes" I agree that the above statement is true.
By selecting "No" I agree that the above statement is NOT true.