Low Income Home Energy Assistance Program (LIHEAP) for Administrators

FY 2025 LIHEAP State Model Plan Draft

LIHEAP 2025 Program Information and Forms

• LI-01-LIHEAP Application
• LI-01 LIHEAP Application Spanish
• LI-02 Vendor Agreement
• LI-03 Self-Declare Zero Income
• LI-04 Poverty Income Guidelines
• LI-05 Landlord Agreement
• LI-06 Self Employment Form
• LI-06 Self Employment Form Spanish
• LI-07 Assurance 16 Service & Usage Tracking Log
• LI-08 LIHEAP Reconciliation Report
• LI-09 LIHEAP Closeout Report
• LI-10 LIHEAP Budget-Amendment 2024
• LI-11 LIHEAP 2022 Invoice
• LIHEAP 25 Workshop Powerpoint
• LIHEAP 2025 Two Page Application
• LIHEAP Landlord Agreement Spanish Version
• LIHEAP Self Declaration Zero Income Spanish Version
• LIHEAP Flyer

Forms

• LIHEAP Authorized Signature Form

Guidance

• 2025 LIHEAP Policy Manual
• LIHEAP Memo 23-01
• LIHEAP Federal Regulations
  
• LIHEAP Q & A Guidance
• Operational Plan Template

Dear LIHEAP Grant Recipient,

As part of federal compliance, all federally funded recipients must ensure their program websites align with the following guidelines:

• Remove any ACF or HHS logos from your website.
• Add a disclaimer clarifying the relationship between your website and federal agencies. For example:

This website is supported by Grant Number [xyz] from the [ACF Office/Program] within the Administration for Children and Families, a division of the U.S. Department of Health and Human Services. Neither the Administration for Children and Families nor any of its components operate, control, are responsible for, or necessarily endorse this website (including, without limitation, its content, technical infrastructure, and policies, and any services or tools provided). The opinions, findings, conclusions, and recommendations expressed are those of the author(s) and do not necessarily reflect the views of the Administration for Children and Families and the [ACF Office/Program].

Additional Resource

LIHEAP Federal Resources

• LIHEAP Virtual Library
• LIHEAP Clearinghouse
• LIHEAP Assurances
• LIHEAP Annual Report

	U.S. Department of Energy's Energy Saver Web Site
	Telling Your Story : A Communications Guide A great little booklet we've written with tips on how you can effectively publicize the work you're doing within your community. As you increase awareness with the public and local officials, the greater support you will have, and the likelihood of gaining additional funding for future projects increases.
	Fair Housing Logo .png image - suitable for printing
	ADA Graphic .png image - suitable for printing

Need more information?
Please send questions to LIHEAP@thda.org.