New Jersey Comfort Partners Program

- Step 1 of 3

Application for Weatherization

Name *

First

Last

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Address *

Address Line 1

Address Line 2

City

State

Zip Code

Would you like to opt in for texts? *

Yes
No

Texts can be stopped at any time.

Email *

Phone (Primary) *

Phone (Secondary)

What is the best time to call?

Choose best number to text: *

Primary
Secondary
Other

Phone # to Text *

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Eligibility Information

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Number of persons (residing in the household) *

Including children.

Unfortunately, you are not eligible at this time.

Based on your answer regarding income. Please visit NJCleanEnergy.com for additional programs.

Gross monthly income (all household residents ages 18+)

Before taxes are taken out.

Is your gross annual income (before taxes) under $36,450 for everyone 18+ in the home?

Yes
No

If your annual income before taxes (everyone 18+ in household) is above this number, then you are not eligible at this time.

Is your gross annual income (before taxes) under $49,300 for everyone 18+ in the home?

Yes
No

If your annual income before taxes (everyone 18+ in household) is above this number, then you are not eligible at this time.

Is your gross annual income (before taxes) under $62,150 for everyone 18+ in the home?

Yes
No

If your annual income before taxes (everyone 18+ in household) is above this number, then you are not eligible at this time.

Is your gross annual income (before taxes) under $75,000 for everyone 18+ in the home?

Yes
No

If your annual income before taxes (everyone 18+ in household) is above this number, then you are not eligible at this time.

Is your gross annual income (before taxes) under $87,850 for everyone 18+ in the home?

Yes
No

If your annual income before taxes (everyone 18+ in household) is above this number, then you are not eligible at this time.

Is your gross annual income (before taxes) under $100,700 for everyone 18+ in the home?

Yes
No

If your annual income before taxes (everyone 18+ in household) is above this number, then you are not eligible at this time.

Is your gross annual income (before taxes) under $113,550 for everyone 18+ in the home?

Yes
No

If your annual income before taxes (everyone 18+ in household) is above this number, then you are not eligible at this time.

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Type of dwelling: *

1 - 14 Unit Dwelling
15+ Dwelling (not eligible)

Is the home within a community that has a homeowner's association? *

Yes
No

Homeowner associations may require written approval on the weatherization scope of work after the energy audit.

Our office may be able to contact the association ahead of time so there are no delays.

Unfortunately, you are not eligible at this time.
If 15+ apartments are attached to your unit, your building type does not qualify. Please visit NJCleanEnergy.com for other assistance programs.

Please choose Yes or No for each row. *

Do you pay directly for your heating? *

Yes
No

If "No" then not eligible. Must be primary account owner.

Is your utility service currently active? *

Yes
No

Unfortunately, you are not eligible at this time.

The utilities must be active to be eligible for the program. Site visit cannot be scheduled until activated.

Was your home built more than 5 years ago? *

Yes
No

If "No" then not eligible at this time.

Unfortunately, you are not eligible at this time.

Homes have to be built more than 5 years ago due to builders warranty. Please visit NJCleanEnergy.com for additional programs.

Have you lived in your home for longer than 1 year?

Yes
No

If "No" then not eligible at this time. Program requires 12 months of utility data to calculate energy usage and savings.

If you would like us to contact you after you have lived in the home for 1 year, please provide your move in date below. If you would like to contact us, you may leave this section blank.

Is the home currently under construction, foreclosure, or for sale? *

No
Yes

If "YES" then not eligible at this time.

Unfortunately, you are not eligible at this time.

IF the home is under construction, please apply once construction is complete. The home cannot be listed for foreclosure and/or for sale at the time of the audit. Please visit NJCleanEnergy.com for additional programs.

Check if you participate in:

HEAP
LIFELINE
PAAD
USF
TANF
SECTION 8
SNAP
SSI (Supplemental Security Income)

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Do you own or rent your home? *

Own
Rent

Since you chose that you have lived the in the home for less than 1 year and own, the program requires 12 months of utility data. Your home is not eligible at this time, however, please submit this application so that we may contact you when you are eligible and provide the move-in date so our office may contact you once it has been at/over 12 months.

Move In Date *

Does not have to be exact,.

Additional Approval Form Required for Renters:

The Landlord Agreement is a form that is signed by the landlord consenting that the home be weatherized. At NO COST to the tenant and landlord. The agreement will be sent via mail or email in advance and must be signed by the landlord prior to the energy audit.

*GreenLife office will reach out to you regarding the landlord agreement.

Do you own your refrigerator? *

Yes
No, owned by landlord

Type of Heating Fuel: *

Natural Gas
Electricity
Oil
Other Fuel

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Name of Electric Company: *

Electric Account Number:

First & Last Name on Electric Account *

Program requires the name on account as part of the enrollment. Name must match name listed on the utility bill.

Does your home have Solar? *

Yes
No

Name of Gas Company: (if applicable) *

Gas Account Number:

First & Last Name on Gas Utility Account *

Program requires the name on account as part of the enrollment. Name must match name listed on the utility bill.

Are you aware of any of the following issues in the home:

Roof leaks
Plumbing leaks
Standing Water in Crawlspace
Smell of gas*
Other

*If you smell gas in your home, please call your gas company's gas leak line or 911 as soon as possible!

If other, please explain. *

Have you ever had Comfort Partners or any other weatherization program before?

Yes
No
Unsure

How did you hear about the program? *

Authorization *

I have read and agree to the terms of use as outlined below.

I certify that all information provided above is correct to the best of my knowledge, and I give the New Jersey Board of Public Utilities, NJ’s Clean Energy Program and participating New Jersey Comfort Partners utilities and contractors permission to: 1) share my records with all parties planning to do work on my home or evaluate my energy usage; 2) use, at no charge, any description or pictures relating to the work performed at my home; and 3) have reasonable access to my home to inspect the work performed. I understand that all work is guaranteed for a period of one year.

Date *

If you have any questions prior to submitting the application,
please contact our office.

info@greenlifeisgood.com

+1-609-407-6900

Hours: 8:30 AM - 5:00 PM, Monday to Friday

Name

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