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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

Non-residential: Non-residential Besides providing heat for your house, does this source provide fuel and/or power for any other buildings, machinery, vehicles, or any other uses, yes or no.

Shut-Off Notice/Need Fuel (Primary Hearing):

These two questions are to assist the county social service board in determining when an application must be processed under the emergency procedures outlined in 15-05-20.

Utility Vendor:

Name of Vendor that supplies non-heating utilities (lights).

Supplier name, address:

This should be the name and city of the supplier for the heat or utility source specified.

Name on Bill:

Enter the name of the household member whose name is indicated on the heating or utility supplier’s account.

Account #:

This should be obtained if at all possible whenever the supplier uses customer account numbers. It is mandatory for Xcel Energy, MDU, Ottertail, and Ferrellgas.

The applicant must provide copies of ALL heating bills, paid or unpaid, incurred since October 1 of the current fiscal year, for which a Miscellaneous payment will be made. (See 35-20-10.)

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