Department of Social Services
Family Support Division
PO Box 2320
Jefferson City, Missouri
TO: ALL FAMILY SUPPORT OFFICES
FROM: KIM EVANS, DIRECTOR
SUBJECT: LOW INCOME HOME ENERGY ASSISTANCE PROGRAM (LIHEAP) FORMS ADDED TO THE DEPARTMENT OF SOCIAL SERVICES (DSS) FORMS MANUAL
DISCUSSION:
The following forms related to LIHEAP can now be found in the DSSManuals Forms Manual:
- LIHEAP Application (English) (Spanish)
- Information Request (LIHEAP-1B)
- Low Income Interview Guide (LIHEAP-1C)
- Employee Wage Documentation Report (LIHEAP-3)
- Energy Assistance Claims & Restitution (LIHEAP-8)
- Energy Assistance Landlord/Renter Documentation Request (EA-1E)
- DCN Update Coversheet
- DSS Confidentiality
- LIHEAP Online Access Request
NECESSARY ACTION:
- Review this memorandum with appropriate staff.
KE/sb