LIHEAP Application

Community Action Agency
150 Lafayette Road
Clarksville TN 37042 (931)896-1800

Have you received assistance under LIHEAP program since October 1, 2024 from any TN LIHEAP Agency? (If yes, you are not eligible to apply) *YesNo

Required Documents – All Must Be Included

1) Household's Gross Monthly Income. You must provide current income for all household members. Examples below:

2) Social Security Cards of ALL household members (copies needed)

3) Valid Government issued ID of all members 18 years or older

4) Past 12 Months Usage Printout Required (Must Contact Utility Co.)

5) Current Utility Bill (Electric, propane, natural gas)

6) To Claim Military or Veteran Status acceptable documents required (DD-214/Military/Veteran ID)

IF ALL DOCUMENTATION REQUIRED IS NOT INCLUDED...
YOUR APPLICATION MAY BE DENIED AS BEING INCOMPLETE.

UPLOAD YOUR DOCUMENTS BELOW.

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This project is funded under an agreement with the State of Tennessee
If you have any questions please call our office 931-896-1800