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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
Case Recording 415-05-35 (Revised 10/1/17 ML #3512) View Archives
The case record must contain sufficient information to support a decision regarding eligibility and benefits and duration. The following items should be in LIHEAP case files: 1. Heating Assistance Application (SFN 529); 2. SFN 530 (Eligibility and Benefit Worksheet); 3. Verifications (income, deductions, living arrangements, fuel type, or other factors affecting eligibility or benefits); 4. Emergency Assistance Application (SFN 62) if EA is requested; 5. Action Plan (SFN 11), if referrals for services are made; 6. Copies of all bills entered on the computer by county staff; 7. Copies of any correspondence (excluding notices generated electronically); 8. Copies of any overpayment agreements; 9. Copies of any other optional forms used in the case; and 10. Case narrative.