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Weatherization_Pack

VIEWS: 20 PAGES: 2

									Florida Department of Community Affairs

W E AT H E R I Z AT I O N A S S I S TA N C E P R O G R A M
PROGRAM DESCRIPTION: The Weatherization Assistance Program annually provides grant funds to community
action agencies, local governments, Indian tribes and non-profit agencies to provide specific program services for low-
income families of Florida. These entities provide program services throughout the state.

MISSION: The mission of the program is to reduce the monthly energy burden on low-income households by
improving the energy efficiency of the home.

FUNDING: The program is funded each year by the U.S. Department of Energy and receives supplemental funding from
the U.S. Department of Health and Human Services. The extent of services to be provided depends on available fund-

ELIGIBLE APPLICANTS: For the Weatherization Assistance Program, the total household income may not be more
than 200 percent of the national poverty level. Preference is given to owner-occupied homes, elderly (60 years-plus) or
physically disabled residents, families with children under 12 and households with a high energy burden (repeated high
utility bills).
                                                                                   2009-2010 Household Income Guidelines
TYPES OF ASSISTANCE
● Address air infiltration with weather stripping, caulking,                    Number of People in     Maximum Annual
  thresholds, minor repairs to walls, ceilings and floors, and                     Household            Household Income
  window and door replacement                                                            1                   $21,660
● Install attic and floor insulation (floors in northern climates only)
                                                                                                             $29,140
• Install attic ventilation                                                              2
• Apply solar reflective coating to manufactured homes                                   3                   $36,620
• Install Solar Screens                                                                  4                   $44,100
• Repair or replace inefficient heating and cooling units                                5                   $51,580
● Repair or replace water heaters
                                                                                         6                   $59,060
WEATHERIZATION FACTS
                                                                                     7                     $66,540
• Low-Income families pay an average of 18 percent of their
  annual income for energy, compared with 5 percent for other                        8                     $74,020
  households                                                                 For each additional member of the household
• The average energy expenditure in low-income households is $1,871                           add $7,480
  annually
• As estimated by the U.S. Department of Energy, these services save the weatherization customers an average of
  $413 annually and return an average of $2.72 in energy and non-energy related benefits for every dollar invested

WHERE TO APPLY FOR ASSISTANCE
To find out where to apply for assistance in your county, you may visit the Department of Community Affairs website at:

                                        www.FloridaCommunityDevelopment.org/WAP

Click on the “Community Assistance Local Programs and Contact List.” From the list, choose the county un which you live.
The contact agency providing assistance through these programs is indicated by “WAP-WAP/LIHEAP.”

         You may also contact the Community Assistance Section at:
                                                                                                FLORIDA DEPARTMENT OF
                                                                                                COMMUNITY AFFAIRS
                     Department of Community Affairs
             Division of Housing and Community Development                                      THOMAS G. PELHAM
                       Community Assistance Section                                             SECRETARY
                       2555 Shumard Oak Boulevard                                               2555 SHUMARD OAK BLVD.
                      Tallahassee, Florida 32399-2100                                           TALLAHASSEE, FL 32399-2100
                               850- 488-7541                                                    850-488-8466

(LOCAL OFFICE - NFCAA) 820 Reid Street Palatka, Florida 32177                 Phone(386)385-3954         Fax(386)385-3024
        Documentation of income, proof of identity, homeownership, copies of Social Security Cards for all household
          members, and a copy of the most recent electric bill must be provided to the local agency with application.
                                        WEATHERIZATION ASSISTANCE PROGRAMS
                                                                    CLIENT INTAKE FORM
AGENCY NAME:                                                                                                                       JOB NO:
CLIENT NAME:                                                               OWNER'S NAME:
SOCIAL SECURITY #: (last 4 digits)                                         PHONE NO.:
UNIT ADDRESS:                                                              MAILING ADDRESS:
CITY:                                      ZIP                             COUNTY:                                                 ZIP
LANDLORD AGREEMENT                    YES _____ NO _____                   OWNERSHIP PROOF (source)                                YEAR BUILT:

INCOME ELIGIBILITY: Must include annual income for ALL household members.
Type of Income:                                                                                       Client                        Others in household
A. EMPLOYMENT
B. UNEMPLOYMENT COMPENSATION

C. SOCIAL SECURITY

D. SUPPLEMENTAL INCOME (SSI)
E. RETIREMENT
F. T.A.N.F.
G. OTHER (type)
                                                             Subtotals:
TOTAL HOUSEHOLD INCOME = $

Main Heating Fuel Source (Check one) Propane _____ Natural Gas _____ Electric _____ Wood _____ Other _____
TOTAL # OF PEOPLE                                                  CLIENT CHARACTERISTICS:
RESIDING IN HOUSE:                                                         Check each characteristic of the client who qualifies for assistance.
                                                                           (Client may be counted in more than one category. Client is not a child.)
Utility Bill at time of application $                                      ELDERLY (60 & older)
CHARACTERISTICS OF All PEOPLE IN HOUSE:                                    DISABLED
(Each person may be counted in more than one category)                     N. AMERICAN INDIAN
ELDERLY (60 & older)                                                       HIGH ENERGY BURDEN HOUSEHOLD
DISABLED                                                                   RECURRING HIGH ENERGY BURDEN (LIHEAP Referral)
NATIVE AMERICAN INDIAN                                                     OTHER (Income qualified only)
CHILDREN (2 & under )                                                      UNITS BY OCCUPANCY: check only one below:
CHILDREN (3 to 5 years )                                                   OWNER OCCUPIED HOME
CHILDREN (6 to 12 years)                                                   SINGLE FAMILY RENTER
All other people not included in above                                     MULTI FAMILY
categories                                                                 OWNER MOBILE HOME
                                                                           RENTER MOBILE HOME

CLIENT AGREEMENT:
1. I voluntarily waive the provisions of the Privacy Act in order to permit verification of my income eligibility.
2. I certify that my household meets the income guidelines of this program.
3. I hereby give permission to enter these premises for the purpose of conducting and energy audit and having my home weatherize.
4. I authorize this agency or its representatives to obtain information regarding my utility usage as needed from the appropriate utility company.

CLIENT SIGNATURE:                                                                                     DATE:
A COPY OF THIS CLIENT INTAKE FORM IS REQUIRED FOR EACH PROGRAM FROM WHICH FUNDS WERE UTILIZED ON THIS UNIT.                                      Form CIF-09

								
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