Fuel Assistance Forms & Documents

Please download the following forms or documents as needed or directed by the NEFWC fuel assistance office, fill them out and return the appropriate forms and any required supporting documentation to the appropriate office for your region.

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For Western Massachusetts clients and applicants (Springfield Office):

» Appeal Rights (English version)
» Appeal Rights (en Espanol, NOTIFICACION DEL DERECHO DE APELACION)
» Change of Address form
» Child Support Form
» Child Support Notarization Form
» Financial Assistance Statement
» How to Apply
» How to Apply-(en Espanol)
» Income Verification
» Proxy Authorization Form
» Tenant Landlord Release

For North Central Massachusetts clients and applicants (Fitchburg Office):

» Addendum-Wage Match Form
» Appeal Request Form

» Appeal Rights (English version)
» Appeal Rights (en español, NOTIFICACION DEL DERECHO DE APELACION)
» Change of Address form
» Application Instructions
» Income Verification
» Low Income Form
» Proxy Authorization Form
» Referrals
» Rental Information Release
» Workers' Compensation Form

Communities served by the Fitchburg office include: Ashburnham, Ashby, Athol, Ayer, Barre, Berlin, Bolton, Clinton, Fitchburg, Gardner, Hardwick, Harvard, Hubbardston, Lancaster, Leominster, Lunenburg, New Braintree, Petersham, Phillipston, Princeton, Royalston, Shirley, Sterling, Templeton, Townsend, Westminster, and Winchendon.