Income Guidelines & Forms

For more information about Energy Programs provided by the state of Minnesota please visitĀ www.energy.mn.gov.

2013 – 2014 Energy Assistance Application

English Forms:
Change of Address 2013-2014
County Assistance Release 2013-2014
Direct Spousal Support Release 2013-2014
Disability Verification Release 2013-2014
Employer Release 2013-2014
Gift Loan Statement 2013-2014
Interst & Dividend Release 2013-2014
Out of State Unemployment Release 2013-2014
Pension Release 2013-2014
Tribal Income Release 2013-2014
Verification of Income and Expenses 2013-2014
Veterans Benefits Release 2013-2014
Work for Rent Release 2013-2014

Spanish Forms:
County Assistance Release – SPANISH 2013-2014
Disability Income Release – SPANISH 2013-2014
Employer Release – SPANISH 2013-2014
Work for Rent – SPANISH 2013-2014

2013/2014 Income Guidelines:

2014 Maximum Energy Assistance Program Income GuidelinesĀ 2014 Maximum Energy Assistance Program Income Guidelines
Based on 50% SMI or 110%* of federal poverty guidelines, whichever is greater
Household Size Annual Income 3 month Maximum Guidelines Household Size Annual Income 3 month Maximum Guidelines
1 $27,232 $6,808 11 $76,984 $19,246
2 $35,612 $8,903 12 $78,555 $19,638
3 $43,991 $10,997 13 $80,126 $20,031
4 $52,370 $13,092 14 $81,697 $20,424
5 $60,749 $15,187 15* $83,268 $20,817
6 $69,128 $17,282 16* $84,839 $21,209
7 $70,700 $17,675 17* $86,411 $21,602
8 $72,271 $18,067 18* $87,982 $21,995
9 $73,842 $18,460 19* $92,235 $23,058
10 $75,413 $18,853 20* $96,657 $24,164

 

 

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