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VIRGINIA DEPARTMENT OF SOCIAL SERVICES ENERGY ASSISTANCE

10/03 VOLUME IX, CHAPTER C, APPENDIX A, Page 3

HANDLING APPROVAL NOTICE CHANGES CONTINUED

ELEMENT VARIABLE CHANGE ACTION NEEDED Income Total income for everyone in the house is $ . 1. yes or no indicated 2. statement scratched out 3. call reporting change 4. amount changed Verify income unless the change would cause ineligibility. Accept the client’s statement for income amounts in excess of allowable maximum. Vendor Vendor Name Account # No vendor. 1. no indicated 2. statement scratched out 3. call reporting change 4. moved 5. name changed Entry or change of a vendor name requires checking the approved vendor list and confirming fuel type. Change the vendor number and fuel type in the system. If vendor is not on list, contact client and advise who is on the list. Fuel Type You heat your home with dyed kerosene; electricity; natural gas; oil; clear kerosene; coal; wood; bottled gas; or liquid propane 1. no indicated 2. statement scratched out 3. call reporting change 4. vendor changed 5. moved Confirm vendor of record provides the changed fuel type. Change the fuel type and vendor if necessary in the system. Equipment type You heat with a: furnace; radiator; portable heater; vented space heater; baseboard heater; heat pump; fireplace; wood stove; or a coal stove. Your heat source is unknown. 1. no indicated 2. statement scratched out 3. call reporting change 4. vendor changed 5. moved Entry or change of equipment type requires checking both fuel type and vendor. Change the equipment type as well as the vendor number and fuel type in the system if necessary.

TRANSMITTAL #03-3