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Welcome to Heat Up St. Louis!

5 Easy Ways to Give

Heat Up St. Louis, c/o Commerce Bank, P.O. Box 868,
St. Louis, MO 63188
or click here for SECURE online donations

IT’ S IMPORTANT TO INFORM YOUR UTILITY COMPANY, AS A COURTESY, THAT YOU FILLED OUT AN ONLINE APPLICATION, AND ARE WAITING FOR A PLEDGE. THIS STATEMENT MUST BE TRUTHFUL.
 
Proof of Income: Copy of Check Stub Year-to-Date, SSI, Social Security, Unemployment, Pension Awards Letter, OFFICIAL Child Support Form, etc.

5 Easy Ways to Give.

Heat Up St. Louis, c/o Commerce Bank, P.O. Box 868, St. Louis, MO 63188
or click here for SECURE online donations
URGENT: We are only helping with Ameren bills NOW. Go to partnering agency on our website for agencies with LIHEAP funds for SPIRE BILLS help!

5 Easy Ways to Give

Heat Up St. Louis, c/o Commerce Bank, P.O. Box 868,
St. Louis, MO 63188
or click here for SECURE online donations

IT’ S IMPORTANT TO INFORM YOUR UTILITY COMPANY, AS A COURTESY, THAT YOU FILLED OUT AN ONLINE APPLICATION, AND ARE WAITING FOR A PLEDGE. THIS STATEMENT MUST BE TRUTHFUL.
 
Proof of Income: Copy of Check Stub Year-to-Date, SSI, Social Security, Unemployment, Pension Awards Letter, OFFICIAL Child Support Form, etc.

Welcome to Heat Up St. Louis!

Outstate Missouri


URGENT:
We are only helping
with Ameren bills NOW.

Go to partnering agency on our website
for agencies with LIHEAP funds for SPIRE help!

Outstate Missouri

Certification of Zero Income Self Affidavit

Certification of Zero Income Self Affidavit

To be completed by an adult head of household member, who is claiming "Zero Income" from any source. ONLY FILL OUT IF YOU HAVE ZERO INCOME!
Name
Address
I hereby certify that I do not individually receive income from any of the following sources:
a. Wages from employment (including commissions, tips, bonuses, fees, ect.);
b. Income from operation of a business;
c. Rental income from real or personal property;
d. Interest or dividends from assets;
e. Social Security payments, annuities, insurance policies, retirement funds, pensions, or death benefits;
f. Unemployment or disability payments;
g. Public assistance payments;
h. Periodic allowance such as alimony, child support, or gifts received from person not living in my household;
i. Sales from self-employed resources (Avon, Mary Kay, Shaklee, etc.);
j. Any other source not named above.
Choose one:
Under penalty of perjury, I certify that the information presented in this certification is true and accurate to the best of my knowledge. The undersigned further understand(s) that providing false representation herein constitutes an act of fraud. False, misleading or incomplete information may result in the termination or repayment of the Heat-Up St. Louis inc. pledge.
Name
MM slash DD slash YYYY