Follow the steps to successfully complete your application.

1. Press the ‘Get Form’ button to access the application form and open it in your preferred editing tool.
2. Fill in the ‘Date Assigned’ field with the current date.
3. In the ‘For Office Use Only’ section, leave the CIF # field blank for staff use.
4. Indicate whether the DHS/Tribal Town has been verified by selecting ‘Yes’ or ‘No’.
5. Provide your personal details in the ‘Head of Household’ section including your name, phone number, date of birth, tribe, social security number, and roll number.
6. Enter your physical address and mailing address, ensuring both are accurate.
7. Under ‘Household Composition,’ list the names, relationships, social security numbers, dates of birth, tribes, and roll numbers of all household members excluding the head of household.
8. Detail the household income by including all sources of income, such as salaries and benefits. Specify the amount earned and how often, using separate rows for each household member.
9. Answer whether your household has previously applied for Tribal Energy or LIHEAP services and provide the date if applicable.
10. Respond to the questions regarding SNAP benefits and Tribal Town membership by circling ‘Yes’ or ‘No’ and provide additional information as required.
11. Read the Fair Hearing, Fraud, and Privacy Act statements carefully. Acknowledge your understanding by signing where indicated.
12. Complete the ‘Release of Information’ section if you choose to allow another person to access your application information.
13. Finally, sign and date the application. Ensure that all information provided is accurate and truthful.
14. Save your changes, download, print, or share the completed application as needed.

To access the Muscogee (Creek) Nation Energy Program Application, please complete it online today.