All forms are in PDF format (you may download the free Adobe reader).

Forms can be filled out electronically or by hand.

ALL forms must be printed and signed by hand.

English

• DHS-FIA-9780-OHEP-Application for Energy Assistance
• Confidentiality-form-1
• Supplemental Forms
  • DHS-FIA-803-OHEP-Alimony Child Support Form
  • DHS-FIA-804-OHEP-Concern for Personal Safety Privacy Form
  • DHS-FIA-805-OHEP-Crisis Season Declaration Form
  • DHS-FIA – 806 Declaration of Zero Income
  • DHS-FIA-807-OHEP-Household Worksheet
  • DHS-FIA-808-OHEP-Income Verification of Self-Employment
  • DHS-FIA-809-OHEP-Landlord Agreement
  • DHS-FIA-810-OHEP-Physician Certification
  • DHS-FIA-811-OHEP-Proxy Authorization Form
  • DHS-FIA-812-OHEP-Rent – Living Arrangements Form
  • DHS-FIA-813-OHEP-Resource Provider Statement
  • DHS-FIA-814-OHEP-Wage Verification

Español

• DHS-FIA-9780-OHEP-Solicitud de Ayuda Para Energìa
• Supplemental Forms
  • DHS-FIA-810-OHEP Physician Certification Spanish
  • DHS-FIA-803 – OHEP- Alimony Child Support
  • DHS-FIA-804 – OHEP-Concern for Personal Safety Privacy Form
  • DHS-FIA-807 – OHEP-Household Worksheet
  • DHS-FIA-809 – Landlord-Agreement
  • DHS-FIA – 806 DECLARACIÓN DE INGRESO CERO
  • DHS-FIA – 808 -VERIFICACIÓN DE INGRESOS POR TRABAJO INDEPENDIENTE
  • DHS-FIA – 814 -FORMULARIO DE VERIFICACIÓN DE SALARIO
  • SOLICITUD DE AUDIENCIA I MPARCIAL de Maryland SUN BUCKS
  • DHS-FIA – 805 – FORMULARIO DE DECLARACIÓN DE TEMPORADA DE CRISIS
  • DHS-FIA – 811 – FORMULARIO DE AUTORIZACIÓN DE REPRESENTANTE
  • DHS-FIA – 813 – FORMULARIO DE AUTORIZACIÓN DE REPRESENTANTE
  • DHS-FIA – 812 – VERIFICACIÓN DE VIVIENDA (PDF)

Brochures and Other Important Information

• OHEP Brochure – FY26 (English)
• OHEP Brochure – FY26 (Español)