Low-Income Rental Efficiency Program
Offered by CenterPoint Energy, Administered by Energy CENTS Coalition
Tenant Application
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
-
Area Code
Phone Number
Phone Type
Home
Cell
Work
Are you a CenterPoint Energy Customer?
*
Yes
No
CenterPoint Account Number
*
Are you an Xcel Energy Electric Customer?
*
Yes
No
Xcel Energy Account Number
*
Do you Own or Rent?
*
Own
Rent
What type of housing do you live in?
*
Single Family
Duplex
Triplex
Fourplex
Apartment
Mobile Home
Townhouse
Are you a Section 8 Voucher Holder?
*
Yes
No
Are you a SNAP Participant?
*
Yes
No
Are you a WIC Participant?
*
Yes
No
Landlord's Name
*
Landlord's Phone Number:
How many people live in your household?
*
What is your household's gross annual income?
*
Are you currently receiving Energy Assistance?
*
Yes
No
Unknown
If you did not received Energy Assistance within the previous two years, you must provide proof of income. (Copy of federal tax return, copies of pay stubs for one month, proof of public assistance or Social Security payments, etc.) You can upload your information here, fax to 651-774-0445, or mail to Energy CENTS Coalition, 823 E 7th St, St Paul, MN 55106. Click the Browse Files button below to upload your information now.
Browse Files
Upload Income Information
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Facebook Ad
CenterPoint Energy Website
CenterPoint Energy email
CenterPoint Energy mailing
Landlord Referral
Search Engine (Google, Yahoo, etc.)
Recommended by friend
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Date
*
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Month
-
Day
Year
Date
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