Application

To apply for the Weatherization Program, submit all the pages of the application below. In addition, please submit the following:

  1. Proof of ownership for your property. This could be a county property tax statement or DMV title for mobile homes.
  2. Residency verification -Social Security Cards for all adults and birth certificates for all household members. This is not required if currently HEAT eligible.
  3. Proof of income for the last 90 days for all adults. If an adult has no income, an Income Deficit Statement is required. Income verification is not required if currently HEAT eligible.
  4. Copies of recent utility bills

* Please note that this application must be printed and signed to be valid. Typed signatures will not be accepted. To e-sign the application, please contact our office for a verified digital copy.

1-Application

2- Rocky Mountain Power Release Form                                                               Only complete if you are a Rocky Mountain Power Customer

3- Dominion Energy Release Form                                                                           Only complete if you are a Dominion Energy Customer

Submit completed application by mail, fax or email:

Weatherization Assistance Program 2344 W Industry Way Unit 2 Cedar City, UT 84721

Fax: 435-867-8374

email: abrinkerhoff@fivecounty.utah.gov