Follow the steps to complete your application successfully.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Fill in the section for the head of household, including your name, date of birth, and Social Security Number. Make sure to enter your mailing address and phone number. If this address differs from your home address, include it as well. Indicate your citizenship status using the provided codes.
3. Provide your marital status and race/ethnicity (optional). If you are receiving benefits, check the appropriate box to allow the use of your recorded income.
4. Specify your housing situation and main heating source by selecting the appropriate options. If heat is included in your rent, attach the necessary documentation from your landlord.
5. For your chosen utility company or fuel dealer, fill in their name, address, and your account information. Ensure you also list your electric company if applicable.
6. Detail the individuals living in your household, including their names, birthdates, and relationships to you. For those with income, indicate whether you can use their reported income for your application.
7. Complete the income section with all sources for each member of your household. Be specific about the type of income and the monthly amounts.
8. Answer additional questions regarding weatherization services and military service. Provide information as requested.
9. Read through the Certification section carefully, and check all applicable boxes. Sign and date your application in ink.
10. Review your completed application for accuracy and completeness. Save changes, then download or print your form. Lastly, submit your application form and all necessary documents to your local county assistance office.

Start your application for energy assistance by completing the PA HSEA 1 online today.