Required Documentation
To be considered for the Emergency Heating Fund, applicants MUST submit ALL of the following documents (to be uploaded on page 5 of this application).
- Proof of homeownership (deed, mortgage statement, or property tax bill)
- Current valid government-issued photo ID
Proof of income/financial hardship (at least one of the following documents):
- Most recent Social Security benefit award letter
- Unemployment benefits statement
- SNAP benefit verification
- Most recent tax return (first two pages of 1040)
- Two heating bills: current one and one directly preceding it
NOTE:
Preference will be given to previous IMPACCT Brooklyn program participants with existing client profiles.
The funds are specifically for heating-related expenses.
The program is applicable to primary residence only.
The program will provide one-time assistance per household.
IMPORTANT DISCLAIMER
PROGRAM PARTICIPATION AGREEMENT
By applying to this Emergency Heating Fund, I understand and agree to the following:
1. Information Verification:
IMPACCT Brooklyn is authorized to verify all information provided in this application. Deliberately false statements may result in immediate disqualification and potential legal action.
2. Data Privacy:
▪ I consent to IMPACCT Brooklyn using my information for program
administration, reporting, and future community support initiatives.
▪ My personal and financial information will be kept confidential and used only
for the intended purpose of this assistance program.
3. Fund Usage:
▪ Funds will be paid directly to my heating provider
▪Funds cannot be transferred, sold, or used for any purpose other than
heating cost assistance
▪Misuse of funds may result in required repayment and future program
ineligibility
4. Reporting Requirements:
▪ I agree to participate in post-assistance surveys
▪ I understand my information may be used in aggregate reporting to funding
partners
▪ My participation helps improve future community support programs
5. Limited Assistance:
▪ This is a one-time assistance program
▪ Receipt of funds does not guarantee future assistance
▪ Funding is subject to available resources
6. Program Modifications:
▪ IMPACCT Brooklyn reserves the right to modify, suspend, or terminate this
program at any time
▪ All decisions regarding fund allocation are final
Certification
By checking the box below, I certify that:
- I am the legal owner and occupant of the property listed above.
- All information provided is true and correct.
- I understand that funds will be paid directly to my heating provider.
- I have not received emergency heating assistance from IMPACCT Brooklyn in the past 12 months.
- I agree to participate in follow-up surveys about the impact of this assistance.
After pressing submit, please be patient while your documents upload.
