SUPERIOR WATERSHED PARTNERSHIP

INCOME VERIFICATION ASSISTANCE APPLICATION

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Superior Watershed Partnership 1104 North Third St • Marquette, Michigan 49855

Phone: (906) 273-2742 • Fax (906) 273-2741

• email meap@superiorwatersheds.org •Website www.superiorwatersheds.org

This application is intended to be used for households that fall between the 151% and 300% Federal Poverty Level (FPL). 


Households that are 150% FPL and below must apply to the Michigan Department of Health and Human Services for State Emergency Relief (SER) before they are eligible for SWP assistance programs.


APPLICANT INFORMATION (Name & Address must match utility bill. If not, an explanation must be included.)



SERVICE ADDRESS (Must match the address on the energy bill)





MAILING ADDRESS (If different than the service address)





CONTACT INFORMATION:


numbers only, no formating


MI Impact funding through the Michigan Department of Economic Opportunity is intended to lift people out of poverty and above the ALICE threshold, especially as it pertains to the effects COVID-19 pandemic. 




HOUSEHOLD INCOME

Examples of Earned Income: Employment wages, tips & other employee compensation.

Adjusted Net Income from employment or self-employment must be determined by deducting allowable expenses of employment from the gross amount received.  Allowable expenses of employment include:  mandatory withholding taxes (25% of gross), deductions required by the employer as a condition of employment, deductions for health insurance, court-ordered child support, including arrears, and unusual employment related expenses. For earned income, please submit check stubs showing gross income and deductions.  If you get paid weekly, submit the last four check stubs, bi-weekly, submit the last two check stubs or monthly, submit the most recent paystub.

 

Examples of Unearned Income: SSI, Alimony, VA benefits, Pension & Retirement, Unemployment benefits, Workers Comp., Child Support, etc.  For unearned income, please submit statements showing the type of income and any deductions that cover at least the past 30 days. Statements must show the recipient’s name, type of income, award amount and any deductions.

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The SWP has several programs available to assist with electric, heat and water and waste. Programs are dependent on your total household income. Below is a table of our current programs and income limits. If you feel that your household falls within the income parameters, you may submit this application along with your income proofs to be considered.

SWP ASSISTANCE PROGRAMS

MI IMPACT (WATER, SEWER, TRASH)

MI IMPACT

UPPCO ALICE (ELECTRIC)

(HEAT & ELECTRIC)

INCOME VERIFICATION

SER APPROVAL OR SWP INCOME VERIFICATION, IF ABOVE 150% FPL

SWP INCOME VERIFICATION

SWP INCOME VERIFICATION

FEDERAL POVERTY LEVEL (FPL) 2023

0%

300%

151%

300%

151%

200%

Household Size

 

 

 

 

 

 

1

$0

$3,645

$1,829

$3,645

$1,829

$2,430

2

$0

$4,930

$2,474

$4,930

$2,474

$3,287

3

$0

$6,215

$3,118

$6,215

$3,118

$4,143

4

$0

$7,500

$3,763

$7,500

$3,763

$5,000

5

$0

$8,785

$4,408

$8,785

$4,408

$5,857

6

$0

$10,070

$5,052

$10,070

$5,052

$6,713

7

$0

$11,355

$5,697

$11,355

$5,697

$7,570

8

$0

$12,640

$6,342

$12,640

$6,342

$8,427

9

$0

$13,925

$6,986

$13,925

$6,986

$9,283

10

$0

$15,210

$7,631

$15,210

$7,631

$10,140

11

$0

$16,495

$8,275

$16,495

$8,275

$10,997

12

$0

$17,780

$8,920

$17,780

$8,920

$11,853

13

$0

$19,065

$9,565

$19,065

$9,565

$12,710

14

$0

$20,350

$10,209

$20,350

$10,209

$13,567

REQUIRED HOUSEHOLD INFORMATION: Please provide proof of income for all household members from the past 30 days. Please email, mail or fax your ID and proofs of income to the SWP Energy & Climate Office.
Do not enter a dollar sign, numbers only.


SIGNATURE REQUIREMENT

Ø  I hereby submit an application for income qualification for assistance with heat, electric, water and/or waste residential services. I understand that the following information will be used in the determination of my eligibility. I also understand that there may be a delay in processing if information is missing.

 

Ø  UNDER PENALTIES OF PERJURY, I SWEAR OR AFFIRM THAT THIS APPLICATION HAS BEEN EXAMINED BY OR READ TO ME. IF I AM A THIRD PARTY APPLYING ON BEHALF OF ANOTHER PERSON, I SWEAR THAT THIS APPLICATION HAS BEEN EXAMINED BY OR READ TO THE APPLICANT. TO THE BEST OF MY KNOWLEDGE, THE FACTS ARE TRUE AND COMPLETE.


After you submit this application, please allow us up five business days to verify your income.  We will then contact you to complete our requirements.  Once you have completed those requirements along with the income verification approval, your household may be eligible for assistance with energy and/or water-waste utility bills up until September 30, or as funding remains.

Contact Information