2025 COMMUNITY SERVICES INTAKE APPLICATION  Logo
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  • Applications missing any of the documents listed below will not be accepted.

    Birth certificate OR passport for ALL household members

    Driver’s license Photo ID for all household members 18 and older

    Last 30 days proof of income for household members 18 and older

    • Examples: check stubs, Pension/Retirement benefit letter, TANF/SNAP letter, Unemployment Benefits, Child Support, VA Disability Award letter, 2025 award letter for Social Security, SSI,
    • Bank statement and tax forms are NOT accepted. 
    • If self-employed, please request a Statement of Self Employment form from our office.
    • If any household member 18 or older has not received income within the last 30 days, the Declaration of Income Statement on page 4 must be completed

    Copy of CURRENT utility bill (electricity, natural gas, and/or propane)

    • This bill must clearly show the account holder’s name, service, address, account number, and usage.
    • EOAC will not accept utility bills shown on your phone.
    • Disconnection notices are not current bills, but you may provide this along with the most recent billing statement

    Once an application is received with ALL supporting documents, it will be processed in the order it is received and by PRIORITY. Processing time can take up to 30 business days. Failure to provide all required documents will result in your application being discarded. Our office will not be able to provide status unless it has been longer than 30 business days since we received a completed submission. Once the application and been processed, you will be notified of the determination.

    This is not antitlement program All assistance is based oeligibility and availability of funds. You are responsible for your utility bill payments at all times.

     

  • MUST READ BEFORE COMPLETING THIS APPLICATION

  • Applying for Assisatnance

    Applicants must submit a new application with supporting documents every calendar year. Prior year program applications will not be accepted. Incomplete applications will not be accepted. Application must include paper copies of all required documentation.

    Utility Assistance is based on available funding with priority being given to income eligible households with high energy usage and billing. Also given priority are vulnerable households. The Program is not an emergency assistance or entitlement program.You are not guaranteed assistance.

    Vendor Agreements

    EOAC must have an executed Vendor Agreement with the utility provider to make pledges or payments to an account. Applications submitted for vendors without an executed agreement will not be processed for assistance.

    Payment Responsibility

    It is your responsibility to pay your utility bill(s) during the eligibility determination process. Please continue to review your monthly invoices and all correspondence received from your utility company. Non payment of your utility bill(s) may result in the interruption of your services. After a pledge/payment from EOAC has been applied to your account, it will be reflected on your next billing statement.

    Benefit Allowance

    Benefit allowance is based on household income, available funding, and the number of allowable months remaining in the program year at the time the application is reviewed and processed.

    Pledges vs Payments

    Utility companies are contacted after eligibility has been determined, and a pledge has been processed. A pledge is a promise to make payment. A pledge secures your utility account for 45 calendar days. Payments are made to the utility company within the 45 calendar days.

    Credit Balances

    A credit balance on a utility account indicates there is no need for immediate assistance. EOAC will not accept any applications that have a credit balance on their utility account. If you have a credit balance at the time of application processing, you will not be eligible for assistance. You can re-apply once that credit balance has been exhausted.

    Address Changes

    If you move any time after your application has been submitted to our office, it is your responsibility to notify EOAC immediately. Failure to do so will result in the loss of your benefit(s) for the program year.

    Changing Vendors

    After submitting your utility assistance application, we encourage you to not make changes to your utility account including changing vendors, account numbers, and/or service address. Making changes to your account will result in the loss of your benefit(s) for the program year.

    Application Status Check

    EOAC will not be able to provide any status on your application unless it has been more than 30 business days since submission of an application and all required documents.

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  • Economic Opportunities Advancement Corporation

    COMMUNITY SERVICES INTAKE APPLICATION
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  • Utility Providers

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  • Systematic Alien Verification for Entitlements (SAVE) System and US Citizenship/US National

  • The program for which you are applying requires verification that you are a U.S. citizen, a non-citizen national, or a legal resident of the United States. Documentation of your status is required. This agency uses the Systematic Alien Verification for Entitlements (SAVE) System to verify the status of non-citizens.

    I am aware that I am subject to prosecution for providing false or fraudulent information.

    (Please provide a copy of the birth certificate OR passport for everyone in the household and a copy of the ID or driver's license for adults 18 and older.)

    By signing, I certify that the documents I am providing for citizenship verification are true and correct.

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  • DECLARATION OF INCOME STATEMENT

    State the gross income for household members18 or older who have no no documentation of the income received in the 39 day period prior to the date of the application for assistance. did not receive any income within the last 30 days, please complete this form.
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  • My household has no documented proof of income due to the following situation. 

     Please explain the reason for no documented proof of income. 

  • I certify that the above information is true and correct ti the best of my knowledge and belief.

    I understand that the information will be verified to the extent possible; and that I may be subject to prosecution for providing false or fraudulent information. 

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  • Authorization

    All applicants must read and sign.
  • I authorize the Texas Department of Housing and Community Affairs and its contracted agencies to solicit/verify information on my energy billing and consumption histories, both past and future, to the extent that the information is used only to determine program eligibility and to provide data.

    Warning: Section 1001 of the U.S. code makes it a criminal offense to make willful false statements of misrepresentation to any Department or Agency of the U.S. as to any within its jurisdiction. Release to be renewed only if the application changes. I understand that a photocopy of this release is as valid as the original.

  • Certification

    • The information provided is true and correct to the best of my knowledge and belief.
    • My household income has been annualized at the time of application according to pre-established procedures.
    • I understand I may appeal a denial of eligibility, and amount of assistance received, or a delay in service delivery.
    • I authorize the Texas Department of Housing and Community Affairs (TDHCA) and its contracted agencies to solicit or verify information on my utility and/or fuel bills, both past and future to the extent the information is used only to provide data relevant to my application for assistance.
    • I am aware that I am subject to prosecution for providing false, misleading, or fraudulent information.
  • Release of Information

  • I hereby give my permission to the Economic Opportunities Advancement Corporation for the following, and do affirm the stated understandings:

    • EOAC may obtain information to complete my application for assistance or services.
    • EOAC may share necessary information with other individuals or organizations to provide case management services and/or secure resources on my behalf.
    • I understand information will only be shared Standard Information Release EOAC may use my success story, likeness, recording, both audio and video in public relations efforts, and may share same with other entities with or without personal identifying information when doing so shall be for the good of improving community development.
    • I understand EOAC may use my likeness and/or success story in releasing annual report information to State and Federal entities, and in doing so, will provide every assurance that personal identifying information will be redacted.
    • I understand I am not entitled to any compensation for any use of my story or likeness.
    • I will continue to provide income information for Case Management reasons for as long as necessary for EOAC to release me from the EmpowerU Program.
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  • Disability Certification Form

    Please complete and sign only if any household member has a disability.
  • I hereby certify that I am disabled as defined in one of the following:

    • 7(9) of the Rehabilitation Act of 1973
    • 1614 (a) (3) (A) or 223 (D) (1) of the Social Security Act
    • 102 (7) of the Development Disabilities Services and Facilities Construction Act (38 USC Chapter 11 or 15)

  • Under penalty of perjury, I have provided truthful information in this certification. In Texas, under Sec. 37.101 of the PENAL CODE, it is a felony of the third degree to falsify this information.

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  • Self-Certification of Life-Threatening Crisis

    Please complete and sign only if any household member has a life-threatening crisis.
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    I hereby certify that the information above is true and accurate, and that the termination of utility services would be life- threatening to those individuals.

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  • Termination of Services

    All applicants must read and sign.
  • This notice is to inform you that you will be terminated from EOAC programs immediately for the following offenses if committed by you, the applicant, or any household member:

    1.  Belligerent or threatening behavior toward a staff member or any other person(s) while inside or outside any EOAC office.
    2. Verbal abuse, including the use of profanity at or in the presence of a staff member or any person(s), while inside or outside any EOAC office.
    3. Any type of actual physical confrontation toward a staff member or any other person(s) while inside or outside any EOAC office.
    4. Providing a false or misleading information regarding any household member(s
    5. Theft from agency or staff member or any other person(s) while inside or outside any EOAC office. Theft is also identified as not returning EOAC funds refunded by an energy company.
    6. Violation of EOAC concealed and open carry handgun and firearm policy.

    I Acknowledge that once terminated, I will not be allowed to reapply for any services with EOAC for a period of 1-2 years depending on the severity of the violation, and the ban from services will remain in effect even if the person(s) who committed the violation moves out.

    I acknowledge that all documentation of the violation will be maintained in my client file, and that I shall have the right to appeal in writing to the Program Director within 10 days of the violation.

    Applicant has a responsibility to:

    • Provide required information to verify eligibility for assistance whenever the case is opened or reopened
    • Report any changes in the household – income, number of people in the home, etc. which may affect eligibility.
    • Report any changes in utility provider when receiving utility assistance.
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  • ATTENTION: PLEASE KEEP THIS PAGE FOR YOUR RECORDS

  • Energy Saving Tips

  • You can do something to keep your electric bills at their lowest by following these simple steps.

    1. Thermostat setting: You can reduce your air-conditioning cooling cost by as much as 14% simply by increasing the thermostat setting by 1 degree. For energy conservation, we recommend a 78-degree setting.
    2. Insulation: Insulation is designed to keep heat out during the summer and to keep heat m during the winter. Adequate insulation can more than pay for itself in just a few years, with money saved on air- conditioning and heating operation.
    3. Let it breathe: Dirty filters cause unnecessary strain and can lead to equipment breakdowns. Air conditioning servicemen say about half of their trouble calls are traced to dirty filters. We suggest changing or cleaning your filters at least once a month, preferably every two weeks for the best results.
    4. Maintenance: Have your unit checked and cleaned each year to ensure maximum efficiency and long life. Have the coils checked and cleaned to see if they are dirty and check the refrigerant for charge and belts for wear and adjustments.
    5. Efficiency: If your unit is 10 years old or older a new, properly sized, high efficiency system should be installed.
    6. Don't forget your ducts: You can save 5% or more on your atr conditioning costs by having your duct system checked for air leaks and for adequate insulation.
    7. Attic: Attic temperatures sometimes rise to 140 degrees during the summer months. Good attic ventilation will lower the temperature and reduce cooling requirements inside the home.
    8. Air leaks: You can save up to 10% on air-conditioning costs with a well-sealed house. Seal leaks around doors, windows, outlets, switch plates, and plumbing outlets. Weather stripping will make your home more comfortable too.
    9. In the shade: If your house has a lot of windows, particularly on the east and west sides, you save money by shading the window with awnings, solar screens, or shutters. Trees and shrubs that shade your home also help to reduce the air-conditioning workload. Venetian blinds or drapes are helpful as well.
    10. Turn it on: By using kitchen and bathroom exhaust fans to remove excess heat and moisture, you can save each month on your overall cooling bill.
    11. Lower is better: You can save money on your water heating bill by setting the temperature control at a moderate 140 degrees, or as low as needed, and still have plenty of hot water.
    12. Up the chimney: If you close your fireplace damper during the summer and winter, (when not in use), you save on both your cooling and heating bills. Installation of a glass fireplace screen will also help prevent air from going up the chimney.
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