Hot Water Tank Application
Please note: the below services are only available to those within the specified services area: (map or list of counties)

Today's Date(Required)
Name(Required)
Address(Required)
DOB(Required)
Type of assistance requested:(Required)
Must provide documentation of Home Ownership or documentation of Purchasing.
The homeowner must be an enrolled Tribal Member with a CDIB card.
All documentation is to be included with the application. If the amount for the tank and installation exceeds the $750 allowable for O&M Services, the remaining balance is to be paid from the Direct Client Services line item.
Drop files here or
Accepted file types: doc, docx, pdf, heic, Max. file size: 10 MB.
    Please upload your receipt and any supporting documents.

    Reimbursement

    Original receipt must be turned in at the time of application submission, along with any supporting documentation.
    Address

    Vendor Information

    Address
    Today's Date(Required)
    This field is for validation purposes and should be left unchanged.