APPLICATION FOR BLACK HILLS ENERGY AFFORDABILITY PROGRAM (BHEAP)

NOTE: Program is only available to eligible, current residential customers from Colorado Electric and Colorado Gas service areas. Benefit enrollment is limited by the availability of BHEAP funds; therefore, applicants are not guaranteed enrollment in BHEAP. See Program Rules and Requirements.

IMPORTANT: Please continue to pay your utility bill. Applying to the Black Hills Energy Affordability Program does not stop collection activities and non-payment could result in disconnection of service. FAILURE TO MAINTAIN ACTIVE SERVICE DURING THE APPLICATION PROCESS MAY DISQUALIFY YOU FROM ACCEPTANCE TO THIS PROGRAM.

PROGRAM RULES AND REQUIREMENTS:
In order to be accepted into the program, customers must meet certain eligibility requirements including:

  1. Current residential Colorado Electric or Colorado Gas customer.
  2. All applicants must apply for LEAP benefits.
  3. The customer`s household income meets the BHEAP plan criteria relative to the Federal Poverty Level (FPL)guidelines (Gas 200%, Electric 200%).
  4. Upon enrollment, the customer`s affordable bill amount will be calculated as a percent of the customer`s actual household income relative to Federal Poverty Level.
  5. Customer agrees to be enrolled in the company`s Budget Billing program.
  6. All applications will be subject to confidential, third-party verification

Enrollment is limited by the availability of BHEAP funds, customers whose applications have been accepted are not guaranteed enrollment in BHEAP.

Keep this Information for your reference during the application period.
Tariffs: See Program Rules established in Black Hills/Colorado Gas Utility Company, Inc. Gas Tariff Sheet Nos. 69-69.7, Black Hills Gas Distribution, LLC Gas Tariff Sheet Nos. 17-21 or Black Hills Colorado Electric, LLC Tariff Sheet Nos. R65-R74 on file with the Colo. Public Utilities commission.


All fields required for all application types.
1. Name of BHEAP Residential Customer Applicant: First: MI: Last:
    * Enter the name of the person applying for BHEAP enrollment.
2. Household Number:
    * The Household Number is assigned by LEAP and can be found on communications provided to the customer by LEAP. It is usually found in the upper right corner of LEAP communications.
3. Current Black Hills account number:
    The account number is indicated in the top right-hand corner of the Black Hills Energy utility bill of the person's residence where service is being provided.
4. Address of residence where utility (electric or gas service) is provided:
    StreetAddress: City: Zip Code:
5. Primary phone number: () -
6. Secondary phone number: () -
7. Email address:

I declare that the information given by me in this application is true and correct. By checking the box, I provide consent for this application and the Black Hills Energy account record to be subject to one-time, confidential, third-party verification.