Energy and Environmental Services Department EES (rev.06/2017)UTILITIES VERIFICATION STATEMENT FORM You are being asked to complete this form because your tenant has requested assistance, and stated.
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How to fill out the EES (rev online)
Completing the EES (rev) form is an essential step for assisting tenants in demonstrating their utility costs. This guide provides clear, step-by-step instructions to fill out the form correctly and efficiently.
Follow the steps to complete the EES (rev) form online
- Click ‘Get Form’ button to obtain the form and open it in the editor.
- Provide the personal information in Section I, including your first name, middle initial, last name, service address, unit number, city, state, and zip code.
- In Section II, answer the questions about the tenant's residency, your own living situation, and any rental subsidies you may receive. Be sure to provide the monthly amounts where applicable.
- Indicate the monthly amount of rent that the tenant is paying. This is crucial for understanding their financial obligations.
- Select all fuel types included in the rent, such as natural gas, electric, wood, propane, fuel oil, or kerosene.
- For each fuel type, write down the monthly amount that the tenant pays towards those costs. If unsure, use the estimation method described in the form.
- Move on to Section III. Have the landlord complete Section A, or if that’s not possible, the tenant can self-certify in Section B by providing a brief hardship statement.
- Make sure to include the landlord's name, address, telephone number, email address, and signature date in Section A, or the tenant's information in Section B.
- After completing all sections, review the form for accuracy before saving any changes. You can then download, print, or share the completed form as needed.
Complete the EES (rev) form online today to assist tenants with their utility cost verification.
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