THE PAPERWORK REDUCTION ACT OF 1995 (Pub. L. 104-13)Use of this model plan is optional. However, the information requested is required in order to receive a Low Income Home Energy Assistance Program (LIHEAP) grant.Public reporting burden for this collection of information is estimated to average 1 hour per response, including the time for reviewing instructions, gathering and maintaining the data needed, and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. Section 1 Program Components Program Components, 2605(a), 2605(b)(1) - Assurance 1, 2605(c)(1)(C) 1.1 Check which components you will operate under the LIHEAP program. (Note: You must provide information for each component designated here as requested elsewhere in this plan.) Dates of Operation Start Date End Date Heating assistance 10/01/2025 09/30/2026 Cooling assistance Summer crisis assistance Winter crisis assistance Year-round crisis assistance 10/01/2025 09/30/2026 Weatherization assistance Provide further explanation for the dates of operation, if necessary Heating Assistance Natural Gas and Electric Heat: the benefit amount households are approved for will be applied to any unpaid heating charges from regular meter read dates from October 1 through May 15. Propane and Fuel Oil: the benefit amount households are approved for will be applied to any unpaid heating charges from tank fills from July 1 through April 30. Crisis All heat types are eligible for crisis assistance between October 1 and March 31, between April 1 and September 30 only electric households are eligible for crisis. Furnace repair/replacement is a year round program. Estimated Funding Allocation, 2604(C), 2605(k)(1), 2605(b)(9), 2605(b)(16) - Assurances 9 and 16 1.2 Estimate what amount of available LIHEAP funds will be used for each component that you will operate: The total of all percentages must add up to 100%. Percentage ( % ) Prior year totals Heating assistance 74.00% 68.00% Cooling assistance 0.00% 0.00% Summer crisis assistance 0.00% 0.00% Winter crisis assistance 0.00% 0.00% Year-round crisis assistance 18.00% 20.00% Weatherization assistance 0.00% 0.00% Carryover to the following federal fiscal year 0.00% 0.00% Administrative and planning costs 7.00% 10.00% Services to reduce home energy needs including needs assessment (Assurance 16) 1.00% 2.00% Used to develop and implement leveraging activities 0.00% 0.00% TOTAL 100.00% 100.00% Tribal grant recipients: direct-grant tribes, tribal organizations, or territories with allotments of $20,000 or less may use for planning and administration up to 20% of the funds payable. Grant recipients that are direct grant tribes, tribal organizations, or territories with allotments over $20,000 may use for planning and administration purposes up to 20% of the first $20,000 (or $4,000) plus 10% of the funds payable that exceeds $20,000. Any administrative costs in excess of these limits must be paid from non-federal sources. Alternate Use of Crisis Assistance Funds, 2605(c)(1)(C) 1.3 The funds reserved for winter crisis assistance that have not been expended by March 15 will be reprogrammed to: Heating assistance Cooling assistance Weatherization assistance Other (specify:) Categorical Eligibility, 2605(b)(2)(A) - Assurance 2, 2605(c)(1)(A), 2605(b)(8A) - Assurance 8 1.4 Do you consider households categorically eligible if at least one household member receives at least one of the following categories of benefits in the left column below? Yes No If you answered "Yes" to question 1.4, you must complete the table below and answer questions 1.5 and 1.6. Heating Cooling Crisis Weatherization TANF Yes No Yes No Yes No Yes No SSI Yes No Yes No Yes No Yes No SNAP Yes No Yes No Yes No Yes No Means-tested Veterans Programs Yes No Yes No Yes No Yes No 1.4a. Provide your definition of categorical eligibility. Please explain how households are categorically eligible (i.e, do all household members need to receive the benefits or just one member, is there a data exchange in place?) and how categorical eligibility streamlines the LIHEAP application process. "Categorically income eligible," if all individuals on the low income energy assistance application receive supplemental nutrition assistance benefits, the household is deemed income eligible for the low income energy assistance program; 1.5 Do you automatically enroll households without a direct annual application? Yes No If Yes, explain: 1) Households whose income has previously been verified and only receive these types of income, SSA, SSI, VA, and/or railroad retirement are automatically approved for the program. The COLA is applied to the previous years income and updated in our system. A letter is sent to these households with this updated information to inform them of the approval as well as to ask them to report any significant changes either to income or household composition. 2) A match is done with the previous years LIHEAP eligible household list and the SNAP eligibility file. The match is based on individual recipient id numbers to ensure the household composition is the same as the LIEAP composition. The Energy Assistance workers verify income, address, and household composition in the SNAP eligibility system and if eligible, approve their case. 3) All other households are sent a LIEAP application and are required to provide updated income verifications as well as verify that their household composition, heat and electric information is still accurate. 1.6 How do you ensure there is no difference in the treatment of categorically eligible households from those not receiving other public assistance when determining eligibility and benefit amounts? Households receiving benefits through programs administered by the State of South Dakota, such as TANF, child support, shall not be required to verify the amount of those benefits because the information is accessible to LIHEAP staff. Households receiving benefits through programs administered by the State of South Dakota that have already verified household income received within the LIHEAP eligibility determination period, shall not be required to re-verify that income if the information is accessible to LIHEAP staff. Verification contained in other systems administered by the State of South Dakota is considered part of the client file. LIHEAP eligibility staff narrate how the information was verified using the worksheet and/or narrative on the LIHEAP eligibility system. LIHEAP staff request the household provide additional information regarding income or household composition if LIHEAP staff determine the request is necessary for accurately determining eligibility. SNAP Nominal Payments 1.7a Do you allocate LIHEAP funds toward a nominal payment for SNAP households? Yes No If you answered "Yes" to question 1.7a, you must provide a response to questions 1.7b, 1.7c, and 1.7d. 1.7b Amount of Nominal Assistance: $0.00 1.7c Frequency of Assistance Once Per Year Once every five years Other - Describe: 1.7d How do you confirm that the household receiving a nominal payment has an energy cost or need? Determination of Eligibility - Countable Income 1.8. In determining a household's income eligibility for LIHEAP, do you use gross income or net income? Gross Income Net Income Other - Describe 1.9. Select all the applicable forms of countable income used to determine a household's income eligibility for LIHEAP Wages Self - Employment Income Contract Income Payments from mortgage or Sales Contracts Unemployment insurance Strike Pay Social Security Administration (SSA ) benefits Including MediCare deduction Excluding MediCare deduction Supplemental Security Income (SSI ) Retirement / pension benefits General Assistance benefits Temporary Assistance for Needy Families (TANF) benefits Loans that need to be repaid Cash gifts Savings account balance One-time lump-sum payments, such as rebates/credits, winnings from lotteries, refund deposits, etc. Jury duty compensation Rental income Income from employment through Workforce Investment Act (WIA) Income from work study programs Alimony Child support Interest, dividends, or royalties Commissions Legal settlements Insurance payments made directly to the insured Insurance payments made specifically for the repayment of a bill, debt, or estimate Veterans Administration (VA) benefits Earned income of a child under the age of 18 Balance of retirement, pension, or annuity accounts where funds cannot be withdrawn without a penalty. Income tax refunds Stipends from senior companion programs, such as VISTA Funds received by household for the care of a foster child Ameri-Corp Program payments for living allowances, earnings, and in-kind aid Reimbursements (for mileage, gas, lodging, meals, etc.) Other If any of the above questions require further explanation or clarification that could not be made in the fields provided, attach a document with said explanation here. 1.10 Do you have an online application process Yes No 1.10a If yes, describe the type of online application (Select all boxes that apply) A PDF version of the application is available online and can be downloaded, filled out and mailed in for processing. A state-wide online application that allows a customer to complete data entry and submit an application electronically for processing. One or more locally available online applications that allows a customer to complete data entry and submit an application electronically for processing. Online application that is also mobile friendly Other, please describe Please include a link(s) to a statewide application, if available: https://www.sd.gov/cs?id=sc_cat_item&sys_id=a254bd6edbf7f410b2fb93d4f3961974 1.10b Can all program components be applied for online? Yes No If no, explain which components can and cannot be applied for online. Furnace Repair/Replacement 1.11 Do you have a process for conducting and completing applications by phone Yes No 1.12 Do you or any of your subrecipients require in person appointments in order to apply Yes No If yes, please provide more information regarding why in-person appointments are required and in what circumstances they are required. 1.13 How can applicants submit documentation for verification? Select all that apply: In-person Mail Email Portal application Other, please describe Hidden for Section 1

Reg 1 Reg 2 Reg 3 Reg 4 Reg 1 Reg 2 Reg 3 Reg 4 742 770 812 854 Income Tier 1 0-Mid HIR 800 800 850 850 668 694 730 768 Income Tier 2 Mid-Max 800 800 850 850 Electric 1331 1410 1516 1626 Income Tier 1 0-Mid HIR 800 800 850 850 1198 1270 1369 1461 Income Tier 2 Mid-Max 800 800 850 850 Fuel Oil 2858 3018 3236 3437 Income Tier 1 0-Mid Fuel Oil 800 800 850 850 2573 2715 2910 3093 Income Tier 2 Mid-Max 800 800 850 850 Natural Gas 880 938 1007 1058 Income Tier 1 0-Mid Natural Gas 800 800 850 850 792 844 907 953 Income Tier 2 Mid-Max 800 800 850 850 Propane 2499 2658 2834 3066 Income Tier 1 0-Mid Propane 800 800 850 850 2249 2394 2552 2762 Income Tier 2 Mid-Max 800 800 850 850 Own and Rent Cases: Heat in Rent Cases: Coal & Wood