Application Casa Verde PDF Details

Navigating the Casa Verde Weatherization Assistance Program begins with understanding the comprehensive application process, designed to facilitate energy efficiency improvements for qualifying households. This form gathers detailed personal information, including name, address, and financial details, such as total gross monthly income and income type, to assess eligibility. It also inquires about additional occupants, their incomes, and whether or not the applicant is a homeowner or a renter. Furthermore, it delves into specifics about the property in question—type, heating and air conditioning systems, and the energy sources that power them. Applicants are required to authorize the CPS Energy and its contracted agencies to verify this information and consent to participate fully in the program's phases, acknowledging the obligations and responsibilities this entails. A striking aspect is the emphasis on honesty and the legal repercussions of fraudulent claims, underscoring the program's integrity. The form also touches on collaboration with other agencies to maximize the benefits for the applicant's home, highlighting a broader commitment to improving energy efficiency and conservation in the community. Understanding this form is crucial for anyone looking to apply for the Casa Verde program, as it lays the groundwork for the assistance and improvements that can contribute significantly to reducing energy bills and enhancing living conditions.

QuestionAnswer
Form NameApplication Casa Verde
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namescasa verde cps application, program casa verde, application casa verde, cps weatherization program application

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Casa Verde Weatherization Assistance Program Application

Applicant Information

First Name

Last Name

CPS Energy Account Number

Street Address

City

Zip Code

County

District Number

Primary Phone Number

Alternate Phone Number

Date Of Birth

Social Security Number

E-mail

 

Total Gross Monthly Income

Income Type (e.g. Self-Employed, TANF, Annuity)

Additional Occupants

That Live At This Address

Date of

Birth

Total Gross

Monthly Income

Income Type

(e.g. Self-Employed, TANF, Annuity)

Social Security Number

(If over 18 years of age)

Disabled: Yes

No

 

Do You Have Access To The Internet? Yes

No

Do you Have Mobile Internet Access Such As A Smart Phone? Yes

No

 

Do You Own The Property Or Are You Renting? Own

Rent

 

 

How Did You Learn Of This Program?

 

 

 

Information About The Property

Year House Was Built

 

 

 

 

 

Date Last Weatherized

 

 

Property Type: Private House

Mobile Home

Low Rent Federal Subsidized Housing

Apartment

Room

Heating Unit Used: Cook Stove – Oven

Electric Heat Pump

Unvented Space Heater

Furnace - Wall or Central

Energy Used to Heat Household: Natural Gas

 

Electricity

 

Bottled Gas

Other

 

 

Air Condition Used: None

Central Unit

 

Window Unit

Evaporative Cooler

 

 

What type Of Water Heater?

Natural Gas

 

Electricity

 

Solar Water Heater

 

 

 

Does Your Residence Have A Programmable Thermostat/Timers? Yes

No

 

 

 

Does Your Residence Have A Swimming Pool Pump? Yes

No

 

 

 

 

Casa Verde Weatherization Assistance Program Application

CASA Verde SA Applicant’s Authorization, Understanding and Agreement

My answers to all of the previous questions and to the statements I have made are true and correct to the best of my knowledge. I authorize the CPS Energy and its contracted agencies to contact any source in order to solicit/verify information necessary for an eligibility determination. I also agree to provide the CPS Energy and its contracting agencies with any information necessary to verify my eligibility. If I am eligible for weatherization services, I give my permission to allow work on the residence listed on this form. I will cooperate fully with Casa Verde by making myself available at ALL phases of the program (assessment, installation, inal inspection). Failure to do so could result in forfeiture of the (1) YEAR WARRANTY on the MEASURES INSTALLED. I have been informed that the home may be dusty upon completion of work and I will not hold CPS Energy responsible for cleaning upon completion. I have been advised and understand that this application will be considered without regard to race, color, religion, creed, national origin, sex, or political belief.

PENALTIES FOR FRAUD!

Whoever obtains or attempts to obtain weatherization services for which he or she is not entitled, by means of willful false statements or other fraudulent means, may be considered guilty of a criminal offense and upon conviction may be ined and/or imprisoned.

NOTE: BEFORE YOU SIGN, BE SURE EACH ANSWER IS COMPLETE AND ACCURATE.

I hereby authorize CPS Energy and the City of San Antonio to release all enclosed application information to other agencies offering similar programs for beneit of the home (i.e. minor repairs, energy and water eficiency, generation and conservation).

Applicant Signature

Date

 

 

 

Signature – Individual making application on applicants behalf or caseworker who assisted in completion of application

Date

 

 

 

In-Take Representative

Date

 

Home Manager Applicant’s Authorization, Understanding and Agreement.

My answers to all of the previous questions and to the statements I have made are true and correct to the best of my knowledge. By signing below, I acknowledge that I understand the qualiications necessary for enrollment in the Home Manager Program and once approved for participation in the Program, I agree to the terms of Program participation which have been provided to me and which are located at www.cpsenergysavers.com.

Applicant Signature

Date

 

 

 

Signature – Individual making application on applicants behalf or caseworker who assisted in completion of application

Date

 

 

 

In-Take Representative

Date

 

CVAPP10/13

How to Edit Application Casa Verde Online for Free

This PDF editor makes it easy to complete documents. You won't need to undertake much to manage cps energy casa verde applications documents. Basically stick to all of these steps.

Step 1: You should click the orange "Get Form Now" button at the top of the following webpage.

Step 2: The form editing page is presently open. You can include information or edit present content.

In order to fill in the verde casa program PDF, provide the content for all of the parts:

example of empty fields in cps energy casa verde

You should enter your data inside the section Disabled Yes, Do You Have Access To The Internet, Do you Have Mobile Internet Access, Do You Own The Property Or Are You, Rent, How Did You Learn Of This Program, Information About The Property, Year House Was Built, Date Last Weatherized, Property Type Private House, Mobile Home, Low Rent Federal Subsidized Housing, Apartment, and Room.

stage 2 to filling out cps energy casa verde

The software will require details to easily submit the section Heating Unit Used Cook Stove Oven, Electric Heat Pump, Unvented Space Heater, Furnace Wall or Central, Energy Used to Heat Household, Electricity, Bottled Gas, Other, Air Condition Used None, Central Unit, Window Unit, Evaporative Cooler, What type Of Water Heater Natural, Electricity, and Solar Water Heater.

Heating Unit Used Cook Stove  Oven, Electric Heat Pump, Unvented Space Heater, Furnace  Wall or Central, Energy Used to Heat Household, Electricity, Bottled Gas, Other, Air Condition Used None, Central Unit, Window Unit, Evaporative Cooler, What type Of Water Heater Natural, Electricity, and Solar Water Heater in cps energy casa verde

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