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Income Guidelines & Application Requirements

        Eligibility is determined by the last 30 days of gross income. Monthly income cannot exceed the amount
        listed below for the number of persons living in the household:
           1 person       2 persons       3 persons       4 persons       5 persons       6 persons      7 persons
            $2,091         $2,735          $3,379          $4,022          $4,666          $5,310          $5,430

        Submit a copy of ALL PAGES of the most recent energy bill (for the last 30 days).
         Utility Account:                    Submit copies of:

         Gas & Electric (PG&E)               ALL pages of most recent bill and shutoff notice if applicable.

         Wood or Propane Account             Recent statement or invoice and a copy of the most recent utility bill.
         Sub-Metered Utilities               Most recent rent receipt showing your gas and electric costs.
                                             Letter from your landlord stating the total amount of rent that goes
         Utilities Included in Rent
                                             towards monthly energy costs or a   CCES Certification Form.

        Submit copies of income documents for the LAST 30 DAYS for ALL adults in the household receiving
        income or aid. Adult household members with no income must submit a written statement explaining
        how they support themselves in absence of income.

         Income Received:                    Submit copies of:
                                             Current  copy  of  paycheck  stubs  covering  one  full  month  (if  paid
         Wages/Earned Income                 weekly last 4 pay stubs; if paid bi-weekly last 2 pay stubs), letter or
                                             printout from employer with gross amount and time period.
                                             Copy of current check, most recent bank statement showing direct
         SSI/SSP/SSA                         deposit,  dated  annual  benefit  letter,  payee  letter  showing  income
                                             amount, Form 4926, Form 2458, HUD statement with a SS amount.
         Pensions, Annuities,                Current copy of check, pension verification, annual statement, bank
         Interest/Dividend Income            statement showing direct deposit.
                                             Current  copy  of  check,  Notice  of  Action,  Passport  to  Services,
         General Assistance/                 verification from worker with amount & date, food stamp verification,
                                             or aid summary, CalFresh award letter.
         Workers Comp., Disability,          Current copy of checks/check stub, printout, or award letter
         Unemployment Benefits
                                             Current court document, copy of check, current signed statement
         Child/Spouse/Individual Support
                                             from person providing report, notice of action showing support
                                             Current copy of check, benefit letter, letter of verification from VA, or
         Veteran's Benefits
                                             copy of bank statement showing direct deposit
                                             Copy of ledger/journal, signed self-employment statement showing
                                             month, gross receipts, gross expenses and net income, 1040 form
                                             Written statement for odd jobs with dollar amounts and dates, current
                                             receipts for recycled materials.
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