NEIGHBOR FOR NEIGHBOR HEAT FUND

ELIGIBILITY WORKSHEET

Are you in need of assistance with your gas bill?  The Salvation Army (Buffalo) can assist you!!!!

Due to COVID-19 we are not completing face to face case management, but you can mail in or drop off your information to:

The Salvation Army (BAS)
Attn: Lisa Holmes
960 Main Street
Buffalo NY 14202

Eligibility (must have one of the categories below):

• Applicant 55 years or older
• Applicant/Household member is handicapped or disabled (attach proof)
• Applicant/Household member has a medical emergency (attach medical statement)

Nature of Handicap or Medical Emergency

• Applicant receiving unemployment benefits
• Veteran of the United States Armed Forces

If you qualify, I will need the following information and documents:

r  On a sheet of paper, place the following information

• your name, date of birth, last four numbers of your social security #
• County, address, and phone number. 
• On the same sheet of paper add how much you pay for the following monthly items: food, telephone, cable, loan payments, insurance, clothing, transportation and other.

r  I will need hardcopies of the following documents:

• If you rent (need letter from landlord or receipt from last payment).  If you have a mortgage, need copy of last bill
• Copy of your gas bill and monthly household income (food stamps add budget sheet)
• # of individuals in the household and all their ages
• If you are a veteran, need to submit a copy of your DD214 form

If you have additional questions, please email Lisa at lisa.holmes@use.salvationarmy.org