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LIHEAP MANUAL JANUARY 2022 84
17. Total Number of Children in Household
18. Homebound Members
19. Referral to Weatherization
20. Energy Source for which assistance is being provided
21. Number of People in Household
22. Annual Income
22a. Pure Public Assistance HH
a) Zero to Two {0-2) - Enter the number of children living in the household who, on the date of application, have not reached their third (3rd) birthday.
b) Three to Five (3-5) - Enter the number of children living in the household who, on the date of application, have reached their third (3rd) birthday, but have not reached their sixth (6th) birthday.
c) Six to Twenty (6-20) - Enter the number of children living in the household who, on the date of application, have reached their sixth (6th) birthday, but have not reached their twenty-first (21st) birthday. If none, enter .Q, if more than nine, enter 9.
- enter the appropriate letter to answer (Y) yes or (N)no.
- enter the appropriate letter to answer (Y) yes or (N)no.
- enter the single number which indicates which energy source the assistance is being provided for.
- enter the number of people living in the household as identified on the corresponding Income Worksheet as two digits. For example, a single-person household would be entered as 01.
- from the Income Worksheet, enter here the total annual income for entire household. Example: $5,085 annual income =5085
- enter the appropriate letter to answer (Y) yes or (N) no.