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16 | P a g e October 25 Release of Confidential Information: CHARACTERISTICS AND PURPOSE The Low-Income Home Energy Assistance Program (LIHEAP) and Weatherization Assistance Program (WAP) application provides for each applicant or recipient, including any financially responsible relative or other individual age eighteen (18) or older, to authorize the Release of Confidential Information. This Release allows the Department/local contractor to secure information necessary for determining a household's eligibility and continued eligibility for payments and for meeting federal Quality Control requirements and to collect data (e.g., fuel consumption) to affect program design. This form also guarantees each applicant, recipient, or financially responsible relative or other individual age eighteen (18) or older, the right to know what information they are releasing, to whom the information is being released, and for what purpose or purposes. RESPONSIBILITY - The Release of Confidential Information must be signed by the primary applicant. If the primary applicant refuses to sign this form or if he or she deliberately conceals a source of information, the applicant may be denied LIHEAP eligibility and/or payments. PROCEDURE: Eligibility Worker Responsibilities: 1. Explain the purpose of the form and the policy it embodies to the applicant, recipient, or financially responsible relative or other individual age eighteen (18) or older. 2. List the types of information, required documentation needed, and why. 3. Make copies of the Release of Confidential Information for individuals, companies and sub-grantees from which information is to be requested. 4. File the original copy of the Release of Confidential Information, in case file. Primary Applicant or Authorized Representative Responsibilities: 1. Read Release of Confidential Information carefully 2. Sign and date Release of Confidential Information. 2.3 Sub-Grantee Responsibilities GENERAL RULE – In taking an application, a sub-grantee must: • Explain to the applicant all factors of eligibility that must be verified. • Provide the applicant with information needed to understand the sub- grantee’s authority to investigate eligibility for assistance.