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Low Income Home Energy Assistance Program Division 10 Service 415 Program 415 Chapters 05 - 65 North Dakota Department of Health and Human Services

that a "dummy" number be assigned by the State Office and the county informed.

Phone, Address, County:

Enter for the home to be heated.

Length of Residence:

Self explanatory. This is to help the county identify households who may have applied previously or in another county.

Race, Ethnicity, Sex, Age:

Complete for the head of the household ONLY. This section is for reporting purposes only. If an applicant refuses to complete it, he cannot be required to do so. There will be special codes to handle unavailable information on the computer "Household Data" screen.

Disability

This question is also for reporting and administrative purposes only and cannot be required if the applicant objects to answering it. The definition of handicapped or disabled is included in the definitions section of this manual. (See 05-05)

Household Members:

The head of the household should NOT be listed again in this section. All other members of the household should be listed. Again, information regarding age cannot be required, but it is important to obtain this information if the applicant is willing because it is necessary to identify the age of the oldest member of the household for reporting and other administrative purposes. Obtaining the social security number is not mandatory unless it is