SSCAC HEAP Forms

Home Energy Assistance Required Forms

Below you will find the forms you may need to complete your Home Energy Assistance Application.

HEAP Forms Available in PDF Format

The HEAP Forms Have Been Updated for the 2025-2026 Program Year.

Child Support/Alimony Document Form

Proxy Authorization Form

Employment Income Verification Form

No Income (Zero Income) Statement

Financial Assistance Statement Form

Low Income/No Income Form

No Mortgage/No Homeowner's Insurance Statement Form

Odd Jobs Income Statement Form

Application Addendum Form

No Signature Form

Vendor Change Form

Arrearage Programs

Work directly with utility companies to reduce or eliminate existing utility debt, preventing service shut-offs and restoring financial stability.

Eversource Forgiveness Program

National Grid Arrearage Program

Columbia Gas Arrearage Program

Income Eligibility

Home Energy Assistance Program (HEAP)

Eligibility for the SSCAC Home Energy Assistance Program (also known as Fuel Assistance) for Program Year 2026 is based on household size and the total gross annual income of all household members. To qualify, your household income must be at or below 60% of the Massachusetts estimated State Median Income.

CLICK HERE FOR INCOME ELIGIBILITY

Residence Eligibility

Home Energy Assistance Program (HEAP)

The South Shore Community Action Council provides Home Energy Assistance, also known as Fuel Assistance, to residents of 39 towns on the South Shore, Cape Cod, and the Islands.

CLICK HERE FOR RESIDENCE ELIGIBILITY