HEAP / PIPP
(HOME ENERGY ASSISTANCE PROGRAM / PERCENTAGE INCOME PAYMENT PLAN)
Social Services Direct Number
740-289-2375
HEAP Information & Appointments
740-289-4525
1-888-328-9634
Remember to call this number for HEAP/PIPP appointments. Please do not call the main agency number. Your call cannot be transferred.
Community Action Committee of Pike County
Contact: Karen Minney, HEAP Operations Manager
(740) 289-2375
kminney@pikecac.org
Development Contact:
Sarah Wickham
Sarah.Wickham@Development.ohio.gov
Office of Communications & Marketing • 77 South High Street • P.O. Box 1001 • Columbus, Ohio 43215 • U.S.A. • 614 | 466-2609
The State of Ohio is an Equal Opportunity Employer and Provider of ADA.
HEAP/PIPP FORMS
PIPP Client Information Form (Online/Drop Off Only)
Self-Declaration of Income Worksheet
Self-Employment Income/Expense Form
Seasonal Employment Verification Form
Employment Verification Form (if paystubs or pay statement from employer is not available)
Letter of Support
Document of Responsibility (if utility is in landlord's name but you are responsible to pay it)
CLIENT REQUIRED DOCUMENTS:
Photo ID (primary applicant)
Social Security Cards (all household members)
Current Main Heat and Electric Bill
Verification of Income (see Acceptable Forms of Income listed below)
Section 8 Rental Verification (if applicable)
ACCEPTABLE FORMS OF INCOME
If you receive Wages (including salaries, tips, commissions, and/or bonuses), Social Security, SSI, SSDI (even received by child), Pension, Retirement, OWF/TANF, Unemployment, Employment Disability, Worker's Compensation, Utility Reimbursement from your apartment complex, IRA Profits, Divorce Settlements, Alimony, Active Military Pay, Rental Income. GROSS INCOME VERIFICATION FOR THE LAST 30 DAYS (PAY STUBS, AWARD LETTER, BANK STATEMENT SHOWING DEPOSIT, PAYMENT PRINTOUT OR STATEMENT FROM ISSUING AGENCY).
If you are Self Employment (including owning your own business, babysitting, home party sales, odd jobs), or Seasonal Employment (including construction, landscaping, teachers not paid with 12-month contract): GROSS INCOME VERIFICATION FOR LAST 12 MONTHS (IRS 1040 AND SCHEDULE 1 OF TAX RETURN, SELF EMPLOYMENT INCOME/EXPENSE FORM).
If you have no income or if the household's total eligible income is below the required threshold (there must be a face to face interview with an intake): (SELF-DECLARATION OF INCOME WORKSHEET, MONETARY/HOUSEHOLD ASSISTANCE LETTER, VERIFICATION OF NON-FILING TRANSCRIPT FROM IRS, VERIFICATION OF FOOD ASSISTANCE AND MEDICAL CARD, VERIFICATION OF CHILD SUPPORT RECEIVED, SCHPP; ; PAM VERIFICATION, INCOME EARNED BY DEPENDENT MINORS, TAX REFUND, SERVICE CONNECTED VA DISABILITY COMPENSATION.)
PLEASE NOTE: Other documentation may be required on a case-by-case basis.