L IEAP Web Application for 2017-2018

Before you get started, you’ll need to read the Applicant Rights and Responsibilities and Instructions. Then gather the following information: Full Names, birthdates, and social security numbers (if available) of all persons living in your home.  All household members that are 18 years of age or older must sign the application, they must be present as you complete the online application so that they can sign the signature page.

Documents can be submitted electronically.Before you continue, scan and save documents in a location that you can attach during the application process.

Please gather up the following documents:

  1. A copy of your recent main heating bill and your electric bill. The bill(s)or statement(s) must show the service address, account number, and name.


  2. If you rent, your Landlord needs to complete the LIEAP Rental Verification form.


  3. If you receive rental assistance, we must receive a printout from your local Housing Authority office showing the utility allowance.


  4. Provide proof of GROSS income for everyone in the household; the three most recent consecutive pay stubs for each person in the household; or an Employer Statement form, which you can get from Align.


  5. If anyone in the household receives Social Security benefits: provide a copy of the Social Security benefit award letter, bank statement(s) showing automatic deposit(s) or Tax Form SSA – 1099 Social Security Benefit Statement.


  6. If anyone in the household receives pensions, retirements, and/or annuities: provide a copy of the benefit letter or tax form 1099. (A bank statement cannot be accepted.)


  7. If anyone in the household is self-employed provide a copy of the most recent self-employment tax return forms and appropriate Schedule or a Profit and Loss Statement(prepared by you, a tax advisor or an accountant).


  8. Provide proof if anyone in the household receives Income from Alimony/Spousal Maintenance, POWER/TANF benefits, Unemployment Benefits, Veteran’s Benefits, Workers’ Compensation/Disability/Illness benefits.


  9. If money is received from others, include a signed and dated letter from the person(s)stating frequency and amount.


  10. If there is no income in your household, provide a statement explaining how expenses are being paid OR complete a LIEAP Self Declaration of Zero Income form, which you can get from Align, your local DFS Office or www.lieapwyo.org.


  11. If anyone in the household is unemployed, please provide a completed and signed workforce registration form from the Wyoming Workforce Services. If you are receiving unemployment benefits attach a copy of your unemployment benefit report.


  12. Proof of identification for all NEW household members, which may be a copy of just one of the following: Driver’s license, social security card, birth certificate, medical insurance card, military ID, State issued ID, Passport, current school record(s) or school ID, permanent resident card, registered alien card, crib card.


  13. If anyone in the household is a College student that has no income provide proof of full time class registration.


  14. If anyone in the household is 18 or older and is a High School student provide proof of school attendance.


  15. If you appoint an authorized representative provide a copy of their identification and complete the authorized representative portion of the application on page 1.


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