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are paid utilizing the Zero Income Supplemental Sheet (Appendix J).  All zero income statements should include an acknowledgement that providing false information will subject them to prosecution for falsely obtaining assistance.  Expenses are not considered income. iii. Categorical Eligibility. An applicant’s eligibility for food stamps, supplemental security income (SSI), FITAP and KCSP Assistance or Veterans benefits does not automatically determine income eligibility for LIHEAP. iv. Regular Contributions.  Contributions received by the applicant on a regular basis (i.e. weekly, bi-weekly, monthly, and quarterly) and that are not loans to be repaid must be counted as income.  When an applicant is receiving Regular Contributions, a Statement of Contributions (Appendix K) form must be completed and signed by the contributor. v. Self-Certification.  After all other avenues of documenting income eligibility are exhausted, self-certification is allowable.  However, evidence of the various attempts at proving eligibility must be retained in the client file, including a notarized statement signed by the potential applicant indicating that the applicant has no other proof of income. vi. Income Limits. The Subgrantee must use annually published income eligibility guidelines to determine a household’s income eligibility. The household’s gross monthly income must not exceed the published monthly income limit by household size. The LES system is updated annually to reflect current income guidelines. Subgrantees are notified annually of updated Income Eligibility Guidelines by LHC via a LIHEAP Notice.

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Official source

Louisiana LIHEAP Service Delivery Guide 39 | P a g e

A p r i l 1 , 2 0 2 6

are paid utilizing the Zero Income Supplemental Sheet (Appendix J).  All zero income statements should include an acknowledgement that providing false information will subject them to prosecution for falsely obtaining assistance.  Expenses are not considered income. iii. Categorical Eligibility. An applicant’s eligibility for food stamps, supplemental security income (SSI), FITAP and KCSP Assistance or Veterans benefits does not automatically determine income eligibility for LIHEAP. iv. Regular Contributions.  Contributions received by the applicant on a regular basis (i.e. weekly, bi-weekly, monthly, and quarterly) and that are not loans to be repaid must be counted as income.  When an applicant is receiving Regular Contributions, a Statement of Contributions (Appendix K) form must be completed and signed by the contributor. v. Self-Certification.  After all other avenues of documenting income eligibility are exhausted, self-certification is allowable.  However, evidence of the various attempts at proving eligibility must be retained in the client file, including a notarized statement signed by the potential applicant indicating that the applicant has no other proof of income. vi. Income Limits. The Subgrantee must use annually published income eligibility guidelines to determine a household’s income eligibility. The household’s gross monthly income must not exceed the published monthly income limit by household size. The LES system is updated annually to reflect current income guidelines. Subgrantees are notified annually of updated Income Eligibility Guidelines by LHC via a LIHEAP Notice.