Forms & Applications
Forms and Applications to be downloaded, printed and completed:
Energy Service Agreement for Rental Property Owner – CSD 515C
If you are a renter, this form gives CAPK Energy Program permission from your landlord or their representative to weatherize the property.
Fax your application to (661) 336-5263 or email your application to HEAPOFFICE@CAPK.ORG
Mail or Drop off application at: 300 19th Street, Bakersfield, CA 93301
An applicant must provide copies of the following documentation : Documentation must be current and dated within Six weeks of application date.
1. Current proof of household income:
- Government aided statement – TANF/Cal-Fresh Passport to Services, Social Security, Unemployment, Veterans, Disability, and Educational.
- Earned income – all paystubs received in the last 30 days
- Unearned income – Child support, Spousal support, Adoption/Foster Care assistance
- Self Employed – must have current income tax information
- Pension/Retirement statement
- Certification of income and expenses (43B) – For other or no income.
2. Utility Bill:
- (Gas, Electric, Propane only) Provide all pages of your utility bill and
- Any notices received in the last 30 days. If you have separate gas and electric companies, you must provide both utility bills.
- BILL MUST HAVE AT LEAST 22 BILLING DAYS.
3. Rental Agreement or Mortgage:
4. Proof of Identification Required:
5. Client Education Form:
*IMPORTANT: Additional documents not listed here, may be required. Incomplete applications will not be processed and may be denied upon receipt. Your HEAP application is not a commitment that your bill will be paid. Therefore, you must continue to pay the amount owed on your bill. If eligible, a credit will be sent directly to the utility vendor within 90 days.
For more information, you may contact CAPK HEAP at 2-1-1.