Do I need a notary for the HEAP application?

No. Sign and date page 5 and affirm that the information is true and correct; the application does not require a notary.

Who should complete the HEAP application?

The person primarily responsible for paying the heating bill should complete it. If heat is included in rent, the primary tenant should apply.

What information does the application ask for?

It asks for household member, housing, heating and utility, and income information. The instructions say to answer all questions and complete non-shaded areas.

Akron, NY · Erie County

No notary required

Home Energy Assistance Program Application

This application is for Akron residents seeking Home Energy Assistance Program benefits who need to report household, housing, heating, and income information.

What this form is

The Home Energy Assistance Program application asks about household members, housing, heating and utility costs, income, and other details used to assess eligibility. The person primarily responsible for the heating bill, or the primary tenant when heat is included in rent, should complete it. Answer all questions, complete non-shaded areas, and sign and date the application; the instructions say program dates vary by year.

Who needs it

The person primarily responsible for the heating bill, or the primary tenant when heat is included in rent, should complete and sign the application.

How to submit it

Submit it to the city department named on the form; check the city website for current contact details.

About notarization

This application is signed without a notary; the signer must affirm that the information is true and correct and sign and date page 5.

How to submit this form

1
Download The Application
Download the Home Energy Assistance Program application PDF.
2
Complete The Application
Answer all questions and complete the non-shaded areas in blue or black ink.
3
Gather Supporting Information
Attach additional sheets if needed to list household members or report income.
4
Sign And Submit
Sign and date page 5, then submit the application to the city department named on the form.

Frequently asked questions

Do I need a notary for the HEAP application?: No. Sign and date page 5 and affirm that the information is true and correct; the application does not require a notary.
Who should complete the HEAP application?: The person primarily responsible for paying the heating bill should complete it. If heat is included in rent, the primary tenant should apply.
What information does the application ask for?: It asks for household member, housing, heating and utility, and income information. The instructions say to answer all questions and complete non-shaded areas.
How do I submit the HEAP application?: Submit it to the city department named on the form; check the city website for current contact details.

Need something notarized?

This Home Energy Assistance Program Application doesn’t need a notary — but if you have another Akron form that does, a commissioned online notary can help.