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  • PowerOn and Gas Affordability Program Application

    Offered by Xcel Energy and Administered by the Energy CENTS Coalition
  • Please check the service(s) provided by Xcel Energy:
  • Is your service currently disconnected?

  • If your electric or gas service with Xcel Energy is currently SHUT OFF:

    Complete and Submit this application, then call our office at 651-774-9010 to alert us of your situation.  

  • Did you receive a grant from the Low Income Home Energy Assistance Program (LIHEAP) this heating season (October 1 - September 30)

  • STOP 

    You do not qualify for the POWER On or GAP Program at this time.  

    You must receive a grant from the Energy Assistance Program (LIHEAP) in order to participate in Xcel Energy's Gas Affordability Program and/or POWER On program.  Click on the link below for more information on the Energy Assistance program in Minnesota.

    https://mn.gov/commerce/consumers/consumer-assistance/energy-assistance/

     

  • Is your mailing address different from your service address?
  • Format: (000) 000-0000.
  • Phone type
  • Format: (000) 000-0000.
  • Phone type
  • Do you Own or Rent*
  • Select the option that best describes your home:*
  • Income Sources (Check all that apply)*
  • Enter total MONTHLY Gross Wages for all household members. (We do not include wages for K-12 students)*
  • Enter total MONTHLY Net income from Social Security benefits for all household members: (SSA/SSDI/RSDI,SSDI)*
  • Enter total MONTHLY Net income from Supplemental Security benefits (SSI) for all household members: *
  • Enter total MONTHLY income from MFIP (Minnesota Family Investment Program) for all household members: *
  • Enter total MONTHLY income from General Assistance for all household members: *
  • Enter total MONTHLY income from Diversionary Work Program for all household members: *
  • Enter total MONTHLY income from Veterans' Benefits for all household members: *
  • Enter total MONTHLY Gross income from Workers' Compensation for all household members: *
  • Enter total MONTHLY Gross income from Unemployment Compensation for all household members:(Do NOT include additional Federal Assistance from CARES Act) *
  • Enter total MONTHLY Gross income from Retirement Income (Not Social Security) for all household members: *
  • Enter total MONTHLY Gross income from Pension (Not Social Security) for all household members: *
  • Enter total MONTHLY Gross income from Long Term or Short Term Disability for all household members: *
  • Enter total MONTHLY Gross income from Alimony or Spousal Support for all household members: *
  • Enter total MONTHLY Gross income from Ongoing support from family or friends for all household members: *
  • Self Employment: Add lines 3 + 4 + 5 and 6 on your 2024 IRS 1040 Schedule 1 - tax form. If you did not file as self employed on your last return or if you did not file a return, enter your estimated net income from self employment for the year (Annually)*
  • Please enter what your "other income" is in the space provided above, and enter total MONTHLY Gross income from that income source.*

  • By signing this document, I am giving Energy CENTS Coalition and Xcel Energy permission to obtain information about me and I am agreeing to the following:

    • I agree that I have received Energy Assistance for the current Low Income Home Energy Assistance Program (LIHEAP) federal fiscal year.
    • I agree to allow Xcel Energy to use payment information in the evaluation of the program.
    • I agree to allow the Energy CENTS Coalition to obtain account information, including LIHEAP status, from Xcel Energy necessary to process this application.
    • I understand I must make my monthly bill payment in order to stay in the program, to receive credit toward past due amounts and to prevent service disconnection.
    • I agree to notify Energy CENTS Coalition if there are changes in my income, household size or if I move.
    • I understand that enrollment in this program will automatically cancel my Averaged Monthly Payment enrollment or any other previously agreed upon payment plan.
    • I agree to allow the Energy CENTS Coalition to share any of the above information with other organizations that provide energy assistance, conservation and other services.
    • I agree to allow heating and electricity companies to give data about my account and energy use to the Energy CENTS Coalition for the PowerOn program and any Energy CENTS Coalition conservation programs.
  • Date
     - -
    2 digit month, 2 digit day, 4 digit year
  • Should be Empty: