Heating Assistance Application

Before You Begin

To be considered for the Emergency Heating Fund, you MUST provide ALL of the following documents. You can upload them in Step 4. Clear phone photos are fine.

Don’t have them handy? You can submit your application now and drop off all of your documents in person at 1000 Dean St, Brooklyn, NY within 2 business days. We can’t accept some documents online and the rest in person; it’s all online or all in person.

Required for everyone

Proof of homeownership (deed, mortgage statement, or property tax bill)
Driver’s license, U.S. passport book or card, Military ID, or Permanent Resident Card (Green Card). IDNYC is not accepted.
Proof of income (at least one of the following):
- Most recent Social Security benefit award letter
- Unemployment benefits statement
- Most recent tax return (first two pages of Form 1040)
Proof of hardship: HEAP or SNAP benefit verification
Two heating bills: the current one, and the one directly before it

Please note

Preference will be given to previous IMPACCT Brooklyn program participants with existing client profiles.
Funds are specifically for heating-related expenses.
The program applies to your primary residence only.
The program provides one-time assistance per household.

About You & Your Home

First Name

Last Name

Phone Number

Property Address

City

State

ZIP

Year of Home Purchase

Type of Property

Single Family Home Multi-Family Home (2-4 units) Other

Heating & Household

Upload Your Documents

Upload each document below. You can attach up to 3 files per item (for example, front and back of your ID). Accepted: PDF, JPG, PNG, or iPhone photos (HEIC). Max 10 MB per file.

Using your phone? Tap Take a photo. Lay the document flat in good light and make sure all four corners and all text are visible.

I’ll drop off ALL of my documents in person instead of uploading them. You’ll get your drop-off deadline (2 business days) on the next screen.
Address: 1000 Dean St, Brooklyn, NY

Proof of Homeownership

Deed, mortgage statement, or property tax bill

Choose files

Government-Issued Photo ID

Driver’s license, U.S. passport book or card, Military ID, or Permanent Resident Card (Green Card). IDNYC is not accepted.

Choose files

Proof of Income

One of: Social Security benefit award letter, unemployment benefits statement, or the first two pages of your most recent tax return (Form 1040)

Choose files

Proof of Hardship

HEAP or SNAP benefit verification

Choose files

Heating Bill — Current

Your most recent bill

Choose files

Heating Bill — Previous

The bill directly before your current one

Choose files

Review, Agreement & Submit

Demographics (Required for Grant Reporting)

Race/Ethnicity

Program Participation Agreement

IMPORTANT DISCLAIMER — PROGRAM PARTICIPATION AGREEMENT

By applying to this Emergency Heating Fund, I understand and agree to the following:

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.
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.
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.
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.
Limited Assistance:
- This is a one-time assistance program.
- Receipt of funds does not guarantee future assistance.
- Funding is subject to available resources.
Program Modifications:
- IMPACCT Brooklyn reserves the right to modify, suspend, or terminate this program at any time.
- All decisions regarding fund allocation are final.

I have read and agree to the Program Participation Agreement.

Certification

By checking the box below, I certify that:

I am the legal owner and occupant of the property listed in this application, and it is my primary residence.
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.

I certify that the statements above are true.

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Future of Homes Brooklyn Energy Initiative
Emergency Heating Fund Application

Before You Begin

Required for everyone

Please note

About You & Your Home

Heating & Household

Upload Your Documents

Review, Agreement & Submit

Demographics (Required for Grant Reporting)

Program Participation Agreement

IMPORTANT DISCLAIMER — PROGRAM PARTICIPATION AGREEMENT

Thank you, ! Your application has been received.

Your application

Future of Homes Brooklyn Energy Initiative Emergency Heating Fund Application

Before You Begin

Required for everyone

Please note

About You & Your Home

Heating & Household

Upload Your Documents

Review, Agreement & Submit

Demographics (Required for Grant Reporting)

Program Participation Agreement

IMPORTANT DISCLAIMER — PROGRAM PARTICIPATION AGREEMENT

Thank you, ! Your application has been received.

Your application

Future of Homes Brooklyn Energy Initiative
Emergency Heating Fund Application