COVID-19 Energy Assistance Program (CEAP) Application

INSTRUCTIONS

Please complete and submit only one electricity application for your primary residence (where you reside for more than 6 months of the year). You cannot receive CEAP funding for multiple residences. If you previously applied for and received CEAP funding, you may reapply for your primary residence once more. If you have natural gas service, you may apply separately for natural gas (CEAP) support through your natural gas utility.

After you have provided your information, please sign this form and provide your consent by: (a) if submitting electronically, typing your name(s) in Section 4; or (b) if submitting by mail, you may print the completed form and sign Section 4 by hand. Please ensure that the information provided is accurate and up-to-date.

Once completed, the form can be emailed or printed and mailed to Energy+. Energy+ offers other ways to submit your application. Please contact Energy+ Customer Care, if assistance is required: customercare@energyplus.ca or (519) 621-3530 ext. 4 or 1-877-871-2215.

CEAP funding is limited and applying does not guarantee that Energy+ has CEAP funding remaining. Applications will be processed in the order they are received. For information on lower-income energy support programs available, please visit the Ontario Energy Board's website.

PROGRAM ELIGIBILITY

(Revised January 14, 2021 by the Ontario Energy Board)

You are eligible for this program if you meet the following criteria, as of the date you are applying:

1. You have overdue amounts owing from one or more electricity bills incurred since March 17, 2020, the date of the initial Provincial Declaration of Emergency.

If you previously received funding under this program and are reapplying based on overdue amounts still owing, you may qualify for additional funding up to a total combined maximum credit of $750.

If you are not eligible for CEAP, you may still be eligible for lower-income energy support programs. Please visit the Ontario Energy Board's website for more information. You may also contact Energy+ for more information on entering into an Arrears Payment Agreement.

SECTION 1: NOTICE AND CONSENT

When you submit this completed form to Energy+, the utility is collecting your personal information in accordance with applicable privacy legislation such as the Municipal Freedom of Information and Protection of Privacy Act or the federal Personal Information Protection and Electronic Documents Act and the licence granted to it by the Ontario Energy Board under the Ontario Energy Board Act, 1998.

Your personal information is being collected for the purpose of administering CEAP, including but not limited to, determining your eligibility for CEAP.

In addition, Energy+ may use personal information already collected from you for the purposes of administering your utility account (e.g. any data respecting billing, bill payments, and previous participation in energy support programs), for the purposes of evaluating your eligibility for CEAP and administering CEAP.

The funding for CEAP is provided by the Government of Ontario. Given that, in order to verify and determine whether you were eligible for CEAP and/or otherwise administer CEAP, it may be necessary for Energy+ to share your information with the Ministry of Energy, Northern Development and Mines. If the Ministry requests any of the personal information contained in this form in order to verify your eligibility for CEAP or for audit purposes related to the administration of CEAP, Energy+ will supply it to them. The Ministry may contact you for further information as part of their audit. You are encouraged to retain any documentation that demonstrates you meet the eligibility for CEAP.

By completing and submitting this application form, you are consenting to the collection, use and disclosure of your personal information as described above.

Contact information for the person who can answer questions about the collection of the information in this form is available by reviewing About Your Privacy on the Energy+ website.

SECTION 2: PROGRAM ELIGIBILITY REQUIREMENTS

(Revised January 14, 2021 by the Ontario Energy Board)

1. Do you have overdue amounts owing from one or more electricity bills since March 17, 2020, the date of the initial Provincial Declaration of Emergency?

No - CEAP is a targeted program designed to aid certain customers who have overdue amounts on their electricity bills as a result of the COVID-19 pandemic. This response means your household does not meet the program's eligibility criteria.

Yes - I have overdue amounts owing from one or more electricity bills since March 17, 2020. Energy+ will verify this information.

2. Have you previously applied for and received funding under this program?

Yes - I previously applied and received funding under this program. If eligible, the total of previously received funding and any additional funding will not exceed the new maximum credit of $750.

No - You may be eligible to receive funding, up to a new maximum of $750.

SECTION 3: UTILITY ACCOUNT HOLDER INFORMATION

Before you begin, make sure that you have a copy of your Energy+ electricity bill for reference.

Utility Account Information: Please enter your information exactly as it appears on your Energy+ bill. If your information is not entered as it appears on your bill, your CEAP application may not be able to be processed until the information can be corrected and verified.

Energy+ Account Number:

Account Holder's Full Name(s):

Account Holder's Service Address:

Contact Phone Number:

Contact Email Address:

SECTION 4: DECLARATION

By signing below,

I declare that the information I have provided in this application is true and correct; and
I indicate my consent to the collection, use and disclosure of my personal information as described in this form.

Date:

Name of Account Holder:

Signature of Account Holder:

Clear

Energy+ will review this application and notify you whether you are eligible for CEAP. If approved, a one-time credit amount will appear on your next bill or the following one, depending on where you are in the billing cycle.

You may submit this form online, by clicking the Submit button, or print a copy of this form and submit by mail, email to:

Mail:

Energy+ Inc.

Attention: Customer Care

P.O. Box 1060, 1500 Bishop St. N.

Cambridge, Ontario

N1R 5X6

HAVE QUESTIONS ABOUT THE CEAP APPLICATION FORM?

Contact the Customer Care Department, Monday through Friday between 8:30 am and 4:30 pm. Contact us at customercare@energyplus.ca or 519-621-3530 ext. 4 or 1-877-871-2215.