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Get the free www.lhc.la.govhubfsDocument LibrariesLIHEAP ZERO INCOME STATEMENT FORM

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APPENDIX LINEAR ZERO INCOME STATEMENT FORM Date:I, (Full Name), (SSN)do hereby certify that I am unemployed and have no income for the following reason: (check appropriate reason(s) _ Laid off. Enter
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wwwlhclagovhubfsdocument librariesliheap zero income is a form used to apply for the Low Income Home Energy Assistance Program (LIHEAP) for individuals with zero income.
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The purpose of wwwlhclagovhubfsdocument librariesliheap zero income is to assist individuals with zero income in paying for their home energy expenses through the LIHEAP program.
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