Page 1
Applicant Information
First Name
Last Name
Date of Birth
MDHHS Case ID/NO ID
Do you have a disability or a physical/emotional/mental health condition?
Yes
No
Part A – Household Information
How many people are in your household?
Is anyone in your household under the age of 5?
Yes
No
Is anyone in your household over the age of 60?
Yes
No
Please list everyone who lives in your household, including their date of birth.
A Household Member includes the following people:
Adults, children, children temporarily absent due to illness or employment, and anyone who sleeps and keeps their belongings in your home.
First Name
Last Name
Relationship to You
Date of Birth
Does this person have a disability or a physical/emotional/mental health condition?
Yes
No
Has anyone in your household experienced homelessness in the past 12 months?
Yes
No
Part B – Household Address and Contact Information
Household Contact Information
Primary Email
Primary Phone Number
Household Service Address
Address (Number and Street Name, Apt., etc.)
City
Zip Code
County (These are the counties we serve)
Please select...
Alcona
Alger
Allegan
Alpena
Antrim
Arenac
Baraga
Barry
Bay
Benzie
Berrien
Branch
Calhoun
Cass
Charlevoix
Cheboygan
Chippewa
Clare
Clinton
Crawford
Delta
Dickinson
Eaton
Emmet
Genesee
Gladwin
Gogebic
Grand Traverse
Gratiot
Hillsdale
Houghton
Huron
Ingham
Ionia
Iosco
Iron
Isabella
Jackson
Kalamazoo
Kalkaska
Kent
Keweenaw
Lake
Lapeer
Leelanau
Lenawee
Livingston
Luce
Mackinac
Macomb
Manistee
Marquette
Mason
Mecosta
Menominee
Midland
Missaukee
Monroe
Montcalm
Montmorency
Muskegon
Newaygo
Oakland
Oceana
Ogemaw
Ontonagon
Osceola
Oscoda
Otsego
Ottawa
Presque Isle
Roscommon
Saginaw
Saint Clair
Saint Joseph
Schoolcraft
Shiawassee
Tuscola
Van Buren
Washtenaw
Wayne
Wexford
Mailing Address
(if different than above)
Street Name, Numbers, PO Box #
City
Zip Code
County
Before Next Section
Are you reapplying for MEAP assistance since October 1, 2025?
Yes
No
If yes, has your income or categorical eligibility changed since your last MEAP or SER application during this program year?
Yes
(Complete all sections within application.)
No
(Please Complete Part D, Part E and Part F
(if applicable)
, and complete Part I , and signatures.)
Page 2
Part D – Emergency Need
How do you heat your home?
Wood
Propane
Coal
Natural Gas
Fuel Oil
Other
No Obligation
Electric Heat
(Includes solar panels, boilers, radiators, or baseboard heating, DOES NOT include space heaters)
If Other, explain here:
Check the service(s) you are requesting and the amount needed.
PLEASE NOTE:
We will only assist with either Heat and/or Electricity if you check the below boxes.
Heat
Electricity (non-heating)
Heat
Amount Needed to Resolve Emergency
$
If Prepaid Account, Amount in Account
$
If Deliverable Fuel, % Remaining in Tank?
%
(Payment for deliverable fuel will not be made if, at the time of delivery, it is confirmed that you have more than 30 percent of the fuel remaining in your tank.)
Please attach
itemized
HEATING
utility bill or quote.
Electricity (non-heating)
Amount Needed to Resolve Emergency
$
If Prepaid Account, Amount in Account
$
Please attach
itemized
ELECTRIC
utility bill.
Part E –
Heating Provider Information
Account Number
Name of Provider
Please select...
CONSUMERS ENERGY COMPANY
DTE ENERGY CO
MARQUETTE BOARD OF LIGHT AND POWER
SEMCO ENERGY INC
UPPER PENINSULA POWER COMPANY
1_MY PROVIDER IS NOT LISTED
Name on Account
If not listed, please enter provider below:
Service Address
Service City
Service Zip Code
WE CURRENTLY ONLY HAVE FUNDING FOR AFFORDABLE PAYMENT PLAN ENROLLMENTS.
If you have Consumers, DTE Energy, Marquette Board of Light & Power, SEMCO, or UPPCO electric heating you may be eligible to enroll into an Affordable Payment Plan. If you were disenrolled for non-payment since October 1, 2025, you will not be eligible for enrollment until October 1, 2026but we may be able to help with a subsidy, if you have not received once since October 1, 2025.
Would you be interested in enrolling in an Affordable Payment Plan (APP) with this application?
Yes
No
We are not currently accepting applications for one-time assistance payments.
Has your heat been turned off or have you run out of your only heating fuel source?
Yes
No
If Yes, date service was turned off or when fuel ran out:
Have you received a past due or shut off notice?
Yes
No
If Yes, date service is scheduled to be turned off:
Are you at risk of running out of your only heating fuel source?
Yes
No
If Yes, number of days until fuel runs out:
Part F – Non-heat
Electric Provider Information
Account Number
Name of Provider
Please select...
CONSUMERS ENERGY COMPANY
DTE ENERGY CO
MARQUETTE BOARD OF LIGHT AND POWER
UPPER PENINSULA POWER COMPANY
1_MY PROVIDER IS NOT LISTED
Name on Account
If not listed, please enter provider below:
Service Address
Service City
Service Zip Code
WE CURRENTLY ONLY HAVE FUNDING FOR AFFORDABLE PAYMENT PLAN ENROLLMENTS.
If you Have Consumers Energy, DTE Energy, Marquette Board of Light and Power or UPPCO for your non-heat electric, you may be eligible to enroll into an Affordable Payment Plan. If you were disenrolled for non-payment since October 1, 2025 you will not be eligible for enrollment until October 1, 2026 but we may be able to help with a subsidy, if you have not received once since October 1, 2025.
Would you be interested in enrolling in an Affordable Payment Plan (APP) with this application?
Yes
No
We are not currently accepting applications for one-time assistance payments.
Have you received a past due or shut off notice?
Yes
No
If Yes, date service is scheduled to be turned off:
Has your electricity been turned off?
Yes
No
If Yes, date service was turned off:
Page 3
Part C – Categorical Eligibility
Have you or do you currently receive benefits from Michigan Department of Health and Human Services (MDHHS)?
Yes
No
Please check all the benefits you receive:
Food Assistance Program (SNAP/FAP)
Head Start
Women Infants Children (WIC)
Family Independence Program (TANF/FIP)
State Disability Assistance (SDA)
Supplemental Security Income (SSI)
Other
If Other, explain here:
Household Proofs
Please attach proofs
for the program(s) in which
any household
member is
currently enrolled.
Proof of Program Enrollment
Have you received energy assistance from another agency or through a provider-sponsored program since October 1?
Yes
No
If yes, who was the provider?
Have you applied for State Emergency Relief with MDHHS or MI Bridges for this need in the last 30 days?
Yes
No
Have you applied and been approved for a Home Heating Credit through the Department of Treasury for the current or previous tax year?
Yes
No
Part G – Household Income
Does your household have any income?
Yes
No
If Yes, total monthly income
$
Please check all sources of income that your household expects to receive in the next 30 days and
attach proofs.
Child support
Pension/retirement benefits
Unemployment
Disability benefits
Self-employment income
Veteran’s benefits/Military allotments
Employment/earned income
Social Security benefits
Worker’s Compensation
Money from family/friends
Supplemental Security Income (SSI)
Other, please list (ex: lottery winnings)
Rental income or a land contract, mortgage or other payment payable to a household member
Tribal payments (Energy Assistance/LIHEAP, tribal GA, casino/gambling profit sharing, land claims, etc.)
If Other, explain here:
Recipient Info
First and Last Name
Type of Income or Name of Employer
(If employed)
Gross Monthly Income
(Amount before taxes and expenses)
How Often Received
(Weekly, biweekly, monthly, etc.)
Household Proofs
Please attach proofs
of any income for the home. Please contact our office with any questions or issues with submissions.
Proof of Household Income
Part H – Deductible Expenses
Check all expenses your household pays and attach proof for each checked item.
Health Insurance Premium
Amount
Paid How Often?
Covered Time Period
(1 mo., 3 mos., etc.)
Actual Childcare Costs
(Paid by the employed person, not MDHHS)
Amount
Court Ordered Child Support
Amount
Unusual Employment Related Expenses
Amount
Explain expense:
Deductible Proofs
Please attach proofs of any checked deduction above if not included in your eligibility proofs (i.e. directly deducted from your paystub or benefits)
Proof of Household Deduction
Page 4
Part I – Certification
(Check the box to each certification statement below.)
I/we hereby affirm to provide all requested verifications within eight calendar days and understand failure to do so may result in denial of the application
I/we hereby grant the assisting agency or department authority to release my name and address to the local weatherization operator as part of the Weatherization Referral system.
I/we authorize the release of my case and payment information to the Department of Health and Human Services, its affiliates and/or contracted agencies, for the purpose of research, study, and evaluation of the Low-Income Home Energy Assistance Program (LIHEAP) and the Michigan Energy Assistance Program (MEAP)
I/we hereby grant the energy provider(s) listed in Part E authority to release all available information about my/our account by phone, fax, email and/or the energy providers website.
I/we hereby affirm to have read the application, or had it read and examined by the authorized representative and with knowledge of the penalties for false statements, certify that the statements and information contained in this application are true to the best of my/our knowledge and belief.
I/we authorize the caseworker to execute the MEAP Application with my verbal consent in lieu of my signature after the MEAP Application has been completed and reviewed with me.
Signature Section
Signature of Applicant
Please allow up to 8 days for us to process your application.
Utility holds will not be placed until the application is processed and all verifications are received.
If you are State Emergency Approved for heat or electric ONLY since October 1, 2025, you do not need to upload any eligibility or income documents because MDHHS has already verified income for your household.
If you have a State Emergency Relief co-pay, you must provide the complete MDHHS letter with your application.
If you have already been approved with SWP MEAP since October 1, 2025, and select no changes in eligibility or income, you are not required to upload documents.
If you have fuel oil, propane or wood pellets you can help speed up the process by contacting your provider and requesting that they email us a quote.
If you want to be enrolled in an affordable payment plan with Consumers, DTE, SEMCO or UPPCO, you must complete the Needs Assessment and speak with a caseworker to create an Energy Security Plan.
If you forgot to upload eligibility documents, 30 days proof of income for everyone in home or utility bills, please send them to meap@superiorwatersheds.org.
We serve all 15 Upper Peninsula of Michigan counties and the following counties in Nothern Michigan: Alpena, Antrim, Charlevoix, Cheboygan, Emmet, Leelanau, Montmorency, Otsego and Presque Isle. If you live in an other Michigan county, contact 211 to find a MEAP Grantee near you.
We accept MEAP applications Monday 8:30 AM to Friday 5:00 PM Eastern Time Zone. We do not accept applications on weekends and Federal Holidays.
Contact Information