[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-277693-105":3,"detail-sidebar-cat-1-en-105":81,"doc-detail-277693-en":127},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":74,"head_meta":76,"extra_data":78,"updated_unix":80},105,"en","landlord-verification-form-fuel-assistance-program","Landlord Verification Form - Fuel Assistance Program","","Landlord Verification Form for the Fuel Assistance Program (FAP) and related Electric Assistance. The landlord or manager must complete owner and tenant details, rental terms, utility/fuel inclusion, household occupant list, fuel tank sharing, room count, and housing type. The form explains eligibility requirements: heat included in rent enables heating voucher assistance, while heat not included results in a credit to the tenant’s fuel vendor. Payment processing timelines and W-9 documentation requirements are included.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/template/","Template",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/template/forms/","Forms",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/template/landlord-verification-form-fuel-assistance-program/277693/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/landlord-verification-form-fuel-assistance-program/277693.png","ImageObject",442,249,{"name":42,"@type":43},"Jacob","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-10-24","2026-09-15",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",9,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"Why must a landlord complete this verification form for FAP?","Question",{"text":63,"@type":64},"Renters applying for Fuel Assistance need an accurately completed landlord verification form. Without it, the household cannot receive the benefit.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"What happens if heat is included in the rent versus not included?",{"text":68,"@type":64},"If heat is included and the rent is not subsidized, FAP provides heating voucher(s). If heat is not included in rent, a credit is issued to the tenant’s fuel vendor.",{"name":70,"@type":61,"acceptedAnswer":71},"What documentation does a qualifying landlord need to receive payment?",{"text":72,"@type":64},"The landlord must have a W-9 on file, along with a photocopy of the owner’s Social Security number or Federal ID number for verification.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},277693,1790014840,{"code":4,"msg":82,"data":83},"success",[84,89,94,99,104,109,113,118,123],{"id":85,"doc_module":22,"doc_module_name":25,"category_name":86,"show_sort_weight":87,"slug":88},11,"Presentations",90,"presentations",{"id":90,"doc_module":22,"doc_module_name":25,"category_name":91,"show_sort_weight":92,"slug":93},12,"Resumes",80,"resumes",{"id":95,"doc_module":22,"doc_module_name":25,"category_name":96,"show_sort_weight":97,"slug":98},14,"Invoices",70,"invoices",{"id":100,"doc_module":22,"doc_module_name":25,"category_name":101,"show_sort_weight":102,"slug":103},15,"Posters",60,"posters",{"id":105,"doc_module":22,"doc_module_name":25,"category_name":106,"show_sort_weight":107,"slug":108},16,"Social Media",50,"social-media",{"id":110,"doc_module":22,"doc_module_name":25,"category_name":29,"show_sort_weight":111,"slug":112},17,40,"forms",{"id":114,"doc_module":22,"doc_module_name":25,"category_name":115,"show_sort_weight":116,"slug":117},18,"Letters",30,"letters",{"id":119,"doc_module":22,"doc_module_name":25,"category_name":120,"show_sort_weight":121,"slug":122},21,"Paper Templates",5,"papers-templates",{"id":124,"doc_module":22,"doc_module_name":25,"category_name":125,"show_sort_weight":4,"slug":126},158,"General","general-158",{"code":4,"msg":82,"data":128},{"doc_id":79,"user_id":129,"nickname":42,"user_avatar":130,"doc_module":22,"category_id":110,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":131,"file_id":132,"file_url":133,"file_type":134,"file_size":135,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":26,"language":136,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":137,"faqs":138,"seo_title":139,"seo_description":12,"update_tm":140,"read_time":22},962084931830,"https://ap-avatar.wpscdn.com/davatar_a8503ba1806abce46bf441b54a3ca4cd","FAP FORM \\# 1  \nSouthern NH Services/Rockingham Community Action  \nLANDLORD VERIFICATION  \nTO LANDLORD: Please read the following and complete the reverse side.  \nYour tenant is applying for the Fuel Assistance Program (FAP) . In order to assist us in determining his/her eligibility, we must have accurate information. It is mandatory that all renters with heat included have a Landlord Verification Form completed by the landlord. They cannot get a benefit without this form.  \nPlease make sure all information requested is completed and correct on this form.  \n• If this household is found to be eligible and heat is not included in rent, a credit will be issued to the tenant’s fuel vendor.  \n• If heat is included in rent and the rent is not subsidized, FAP will provide assistance in the form of heating voucher(s) . The heating voucher will be issued in amounts of no more than $315 each month. This may be repeated for a specific number of month(s) until the full benefit amount has been spent. If your tenant’s rent is overdue, please fill in the amount past due on the reverse side. If your tenant pays by the week, make sure to calculate what will be owed for that week plus the remainder of the month. We do not pay by the week.  \n• Checks will be issued within 20 working days of receipt of signed vouchers.  \nAny landlord who qualifies to receive payment from the Fuel Assistance Program must have a W-9 on file. This must be accompanied with a photocopy of owner's Social Security number or Federal ID number for verification purposes. Corporations, Partnerships or Trusts, must submit either stationery which has the Federal Identification number imprinted on the letterhead or a copy of the IRS label/tax form with the completed W-9.  \nThe Fuel Assistance Program can pay heating vouchers from Dec 1, 2021 but only when the heat is included in the rent, and only after the beginning of the program in December 2021. Heating Voucher payments cannot be applied to security deposits or to application fees. Failure to comply with these rules will prohibit you, the  \nlandlord, from participating in the program.  \nIt is the applicant’s responsibility to bring or FAX the completed form back to us at the area office that is indicated below where he/she applied for assistance.  \nYou may mail, fax, or email this form to my attention:  \nAttn:   Telephone (603)   Ext .   \nAddress:  \nEmail:  \nFax:  \nCASE \\#  Attn:    \nSouthern NH Services/Rockingham Community Action  \nFUEL ASSISTANCE /ELECTRIC ASSISTANCE PROGRAM  \nLandlord Verification Form  \nThis form must be completed and signed by the Landlord or Manager  \nOWNER’S NAME:    \nPLEASE PRINT  \nADDRESS:   CITY:   STATE   ZIP   TEL  OWNER’S EMAIL:   MANAGER’S NAME:   TEL   \nTENANT'S NAME:   ADDRESS:   APT \\#   \nCITY:   STATE   ZIP TEL   \n\\# OF ADULTS (18+):   \\# OF CHILDREN (Under 18):   Date of Occupancy:    \nPlease list the name of everyone living in the household:  \n1   2   3  4   5   6   \nRental amount per month: $   If PAST DUE: Month  Amount $   \nPlease note that City Welfare or Town Rental Assistance is not a subsidized program.  \nIs the tenant responsible for the FULL amount of the rent?   YES   NO  \nIf not, Agency Paying   Tenant portion of the basic rent $   \nPlease circle the appropriate answers:  \nUtilities included in rent: Heat Electricity None  \nPRIMARY fuel type: Natural Gas Electricity Oil Propane (LPG) Kerosene Wood  \nSECONDARY fuel type: Natural Gas Electricity Oil Propane (LPG) Kerosene Wood None  \nTotal number of rooms:    DO NOT COUNT bathrooms and hallways.  \nHOUSING TYPE: SINGLE HOUSE DUPLEX MULTI-FAMILY (3+ Apts.) MOBILE HOME ROOM  \nIs the fuel tank shared with other units? Yes  No   \nIT IS MANDATORY THAT ALL RENTERS WITH HEAT INCLUDED IN RENT HAVE THIS FORM COMPLETED!  \n• If a benefit is approved and HEAT IS INCLUDED IN THE RENT, payments will be made payable and sent to the NAME AND ADDRESS LISTED ABOVE IN THE OWNER SECTION.  \n• If a benefit is approved and HEAT IS NOT INCLUDED IN REN","cbCaiim1tuQ5JjqT","https://ap.wps.com/l/cbCaiim1tuQ5JjqT","pdf",210625,"English","# Landlord Verification Instructions\n## Eligibility, Heat Included/Not Included Rules\n## Required Documentation (W-9) and Payment Notes\n# Landlord Verification Form Fields\n## Owner/Manager Information\n## Tenant and Rental Details\n## Utilities and Primary/Secondary Fuel Types\n## Housing Type, Rooms, and Fuel Tank Sharing\n## Signature and Date","[{\"question\":\"Why must a landlord complete this verification form for FAP?\",\"answer\":\"Renters applying for Fuel Assistance need an accurately completed landlord verification form. Without it, the household cannot receive the benefit.\"},{\"question\":\"What happens if heat is included in the rent versus not included?\",\"answer\":\"If heat is included and the rent is not subsidized, FAP provides heating voucher(s). If heat is not included in rent, a credit is issued to the tenant’s fuel vendor.\"},{\"question\":\"What documentation does a qualifying landlord need to receive payment?\",\"answer\":\"The landlord must have a W-9 on file, along with a photocopy of the owner’s Social Security number or Federal ID number for verification.\"}]","Landlord Verification Form - Fuel Assistance Program | PDF",1789503148]