Arrearage Management Program

Application for participation in the State of Maine's Arrearage Management Program

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Section 1: Applicant Information

If yes, please list program(s) and participation date(s)

By signing this application, I: 1) certify that I am eligible for HEAP; 2) request that my electric utility enroll me in its Arrearage Management Program; 3) agree to abide by the terms of the Arrearage Management Program and understand that failure to do so may result in my removal from the program; 4) give my electric utility permission to share all electricity usage data from my residence including the information in this form with the Efficiency Maine Trust; and 5) agree to complete an electricity usage assessment with the Efficiency Maine Trust and understand that my failure to do so will result in my disqualification from the Arrearage Management Program.

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