Wyoming Low Income Energy Assistance Program
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​If you've been asked to complete a specific form, you'll find it below​
Print Application
File Size: 579 kb
File Type: pdf
Download File

Employer Statement
File Size: 141 kb
File Type: pdf
Download File

Work Registration Verification
File Size: 132 kb
File Type: pdf
Download File

Rental Verification
File Size: 148 kb
File Type: pdf
Download File

Self Declaration of Zero Income
File Size: 106 kb
File Type: pdf
Download File

Statement of Incapacity
File Size: 96 kb
File Type: pdf
Download File

Self Declaration of Permanently Parked Traditional Dwelling
File Size: 128 kb
File Type: pdf
Download File

Authorized Representative Release Form
File Size: 161 kb
File Type: pdf
Download File

Questions? Call us at 1-800-246-4221 for help.

Location

1401 Airport Parkway,
​Suite 300
Cheyenne, WY 82001

Need help? call us!

To get specific information about your application or
to ask that an application be mailed to you,
​call: 1-800-246-4221.

join the conversation


Wyoming LIEAP is funded by the U.S. Department of Health and Human Services and
​is administered by the Wyoming Department of Family Services.
  • Home
  • Weatherization Assistance
  • Forms and Application
  • News and Updates
  • Mobile Capture
  • FAQ