Bright Neighborhoods - Income Verification Form

Please note this form takes about 10-15 minutes to complete. You are not able to save your progress if you leave this page before completing and submitting your income eligibility intake form.

Are you interested in having solar on a property (ground or roof) you own?

How many units do you have? (Use 1 for single family homes.)

Do you live in this building?

Notice

If you are interested in income eligibility for a 2-4 unit building, or a building you do not live in, your neighbors must also verify their income. Please fill out the form below to receive a follow up call or email to complete your building’s income verification. If you would like to proceed as an individual, you can complete your income eligibility for a community solar project.

Notice

Income eligibility via this website is not available for buildings with five or more units. If you are interested in income eligibility for households in a 5+ unit building please contact an Approved Vendor. If you are interested in subscribing to a community solar project you can find a list of community projects here. For additional information, please contact the Program Administrator at 1-888-970-ISFA

Owner Info

Owner First Name

Owner Last Name

Owner Phone

Owner Email

Property

Please provide the address for the property where you are interested in having solar installed.
Property Address	Property City
Property State This program is for Illinois Residents only	Property Zip Code
Property County For example “Cook” or “Kane”

Use the submit button below to receive a follow-up call with more information.

Property Characteristics

Please answer the following questions to the best of your ability. Your responses will be a helpful first step in determining whether your home or building is a good fit for solar.

Electrical Information

Electric Utility

Disclaimer: Not all utilities allow their customers to connect a solar installation to their electrical grid.

Other Electric Utility

Do you have a fuse box (cartridge or screw-in fuses that need to be replaced when blown) or an electrical panel with breakers (switches that can be turned on or off and can be reset when “tripped”)? See images below for assistance.

Example

Electrical Fuse Box	Electrical Panel With Breakers

Solar Panel Location

The solar panels can be located on your roof or in your yard. Please answer the questions below to the best of your ability.

Note, you can select more than one option if you're not sure whether roof or ground-mounted solar is better suited for your home or building. Select those that apply.

Where are you interested in installing the solar panels?

I'm interested in installing solar on my roofI'm interested in installing a solar system in my yard or field on my property (*Disclaimer: Not all Approved Solar Companies complete installations on the home’s property. This will vary by Approved Solar Company.)

Roofs must be in good condition to be suitable to host solar systems.
What is the approximate age of your roof?

To adequately assess your roof's condition, the Approved Solar Company will need to view the internal structure. Do you have access to your home’s existing attic?

The system will need to be located where it is unlikely to be flooded. Has your property flooded in the last 5 years?

The system will need to be located where there is minimal or no shading on the roof or property.

Do you have any large trees or buildings that significantly shade the South, East, and/or West facing sides of your property?

Are there any known or observed electrical issues or damage to your property’s roof?

Please note a complete site assessment conducted by an ILSFA Approved Vendor is required to determine if your site is suitable for a solar system.

Income Eligibility Documentation Information

There are four options to choose from. Members over the age of 18, of the household, may use different options to determine income eligibility. For example, one member may provide documentation from Medicaid from Option 1 and additional members may use income information from a credit reporting agency in Option 2. Please keep in mind the programs listed under Option 1, except Medicaid, are household benefits and do not require the use of additional options as proof of income-eligibility for other members of the household.

Option 1:

a: Household proof of enrollment in an income-eligible program

b: Medicaid

Option 2: Income verification through a credit reporting agency

Option 3: Income Affidavit - Low-Income Qualified Census Tract - For residents in a low-income qualified census tract according to the United States Department of Housing and Urban Development (only available to Bright Neighborhoods participants).

Option 4: Income Affidavit - Zero or Undocumented Income - For residents with zero income or undocumented income for 2+ months. This can only be used in limited circumstances and cannot be used if you are able to utilize Option 1a, Option 1b, Option 2, or Option 3.

See if you're eligible For household members over the age of 18, you will select the income eligibility option and documentation in the section below.

Any sensitive personal information must be covered or concealed before submitting. Physically covering information with a piece of paper, on a copy of the document is an example of how to conceal information.

Do not alter your original documents.

Examples of sensitive personal information include social security number, driver’s license number, taxpayer ID number, patient ID number, financial account number, or credit card numbers. Documentation sent with visible sensitive personal information will be immediately deleted or destroyed to protect your privacy and a corrected copy will be requested.

Documentation must be issued by the program and include the program name, recipient name and address, and date issued.

Income Eligibility Documentation of Household Members

Household size and annual income are used to determine eligibility. Income refers to gross income or pretax income. Please list the name, month and year of birth, and annual income for each household member. This includes household members 18 or under. Use the “Add Household Member” button to add a person to your household. If a household member has no income, please enter "0" for their annual income.

Resident First Name

Resident Last Name

Birth Month & Year (Format: MM/YYYY)

Is this household member over 18?

Resident Income Verification Method

After this form is submitted, you will receive an email from the Program Administrator with instructions to collect your personal information to submit to a credit reporting agency.

By selecting Option 3: Income Affidavit, I affirm the following:

The Resident Income I have provided below includes my income from all sources received in the prior calendar year, as reported on my federal Individual Income Tax Return;
I have received no other sources of taxable income not reported on this form over the prior calendar year; and
I understand that the information I am providing is subject to verification by the Program Administrator.

By selecting Option 4: Income Affidavit, I affirm that the information I provided is true, complete and correct to the best of my knowledge and belief and is made in good faith. I also understand that the information I am providing is subject to verification

I attest to the fact that I have received:

This income was received from:

How would you like to submit your documentation?

Mail copies of your documentation to:
Elevate - Illinois Solar for All
322 S Green St., Suite 300
Chicago, IL 60607

Do NOT mail original copies.

Upload Income Verification Documentation

Resident Income

Certifying Household Income Documentation

Head of Household Race (Optional)

NOTE, YOU MAY REPORT MORE THAN ONE GROUP.
Ctrl + Click to highlight multiple options.

"Other" Race Description

I CERTIFY that my household has X number of individuals living in it.
Please enter the total number of members living in your household. This number should match the number of household members added in the previous page.

This includes both children and adults.

I CERTIFY that X number of people living in my house are 18 and above.
Please enter the total number of members over the age of 18 living in your household. This number should match the number of household members over the age of 18 added in the previous page.

I CERTIFY that my household makes no more than 80% of area median income or less based on my county of residence and household size.

I CERTIFY occupancy status

How did you hear about the ILSFA Program?

Please describe how you heard about this program?

Terms & Conditions

Terms and Conditions:

You have read, agree to, and have met all program terms and conditions as outlined in this form.
You have the authority to provide the information in this form. You have the consent of the individuals in your household whose information is included.
All of the information contained in this form and any supporting documentation is complete, true and correct, and all income of the household members has been fully disclosed.
You understand that, subject to applicable law, the information provided in this Income Verification Request Form will be used for the permissible purpose above including, but not limited to, determining program eligibility, monitoring compliance with the program, assessing the program, and modifying and/or improving the program.
You are the property owner or, if you are not the property owner, you have obtained the consent of the property owner to participate in the program.
You consent to the Program Administrator requesting and obtaining income information from the sources listed in this form for the purpose of verifying your household’s eligibility for the program including, but not limited to, the following information: State and federal tax returns and tax return information
Sources of Information: Equifax
Information provided on, or in connection with, this Income Verification Request Form are subject to verification, and you agree to furnish supporting documents or additional information as requested.
You will promptly update or correct any information furnished on, or in connection with, this Income Verification Request Form if you become aware of any change to, or inaccuracy of, such information during your participation in the program.
Intentional misstatements, falsification or failure to update or correct this Income Verification Request Form may result in ineligibility for, or termination from, the program. By submitting this form, you are agreeing to receive emails about Illinois Solar for All from ILSFA Approved Vendors.

By checking this box and submitting this form, you are acknowledging your understanding of, and agreement to, the terms and conditions list above.

Verify Your Income Eligibility for Bright Neighborhoods

ILSFA Bright Neighborhoods Income Eligibility Intake Form