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Official source

page of Form 201SF or question 6 of Form 202. The income limit can be found on the Fuel Program Income Guidelines (P-2913). g. “Line of Credit” • Circle the appropriate “Season %” (100%, 80%, 60%, 40%) based on the application date. (We will be putting the circled percentage on Section II line 4.)

h. Check off if heat is included, if applicant has a wood/pellet benefit, or if it will be an electronic fund transfer (EFT) to the fuel dealer. (If it is EFT indicate dealer name and vendor number.) i. If the client is a roomer or has heat included AND subsidized rent, check the appropriate $21 benefit box.

If you check off one of these two options AND the client is income eligible, you’re done. Complete the bottom portion of form, submit to your supervisor for review, and then e-mail to Fuel and Utility Team: ahs.dcfesdfuelmgmt@vermont.gov.

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Page 4

Official source

page of Form 201SF or question 6 of Form 202. The income limit can be found on the Fuel Program Income Guidelines (P-2913). g. “Line of Credit” • Circle the appropriate “Season %” (100%, 80%, 60%, 40%) based on the application date. (We will be putting the circled percentage on Section II line 4.)

h. Check off if heat is included, if applicant has a wood/pellet benefit, or if it will be an electronic fund transfer (EFT) to the fuel dealer. (If it is EFT indicate dealer name and vendor number.) i. If the client is a roomer or has heat included AND subsidized rent, check the appropriate $21 benefit box.

If you check off one of these two options AND the client is income eligible, you’re done. Complete the bottom portion of form, submit to your supervisor for review, and then e-mail to Fuel and Utility Team: ahs.dcfesdfuelmgmt@vermont.gov.