How to Fill Out and Submit the Eversource Financial Hardship Form

The Eversource financial hardship form is a one-page application that, once approved, protects your household from gas or electric shutoff when you can’t pay the full balance. You fill in your name, address, Social Security number, gas and electric account numbers, household size, and total pre-tax household income, sign and date it, and submit it with proof of income or a public assistance benefit letter. Connecticut customers can upload it online, mail it, or fax it; Massachusetts customers submit through Eversource or a local Community Action Agency.

What the Form Does and Who Can Use It

In Connecticut, hardship status blocks electric or gas shutoff from November 1 through May 1 for any qualifying customer who lacks the resources to pay.¹ Connecticut’s statute defines a hardship case as a household below 125 percent of the federal poverty level, an unemployed head of household below 300 percent, a household with a seriously ill member, or any situation where losing service would be life-threatening.²

Massachusetts protection runs on a different track. Your service cannot be shut off without Department of Public Utilities permission if you’re experiencing financial hardship and at least one additional condition applies: a seriously ill household member, an infant under 12 months, all adults 65 or older with a minor child in the home, or the November 15–March 15 heating window if you use the service for heat.³

You qualify automatically if anyone in your household receives public assistance. Connecticut accepts enrollment in CEAP, SSI, SSDI, TFA/TANF, SAGA, SNAP, Medicaid or HUSKY, Medicare Savings Programs, WIC, Head Start, free or reduced school lunch, VA financial support, or Section 8.⁴ If you’re on one of those, the benefit letter stands in for income documents.

Documents to Gather Before You Start

The form takes a few minutes. The paperwork behind it is where most of the time goes. You need two things: the completed form and proof that supports whichever qualification applies to you.

If you’re on public assistance, make a copy of your current benefit award letter — CEAP, SSI/SSDI, TANF/TFA, SNAP, Medicaid, WIC, VA, or your Section 8 contract or voucher.⁴

If no one in the home receives assistance, pull proof of income for every adult over 18 in the household. What Eversource wants depends on how each adult is paid:

Weekly wages: the last four consecutive pay stubs.
Bi-weekly wages: the last two consecutive pay stubs.
Monthly wages: the most recent pay stub.
Seasonal or fixed-term work: the most recent annual income statement or 1040.
Self-employment: the most recent 1099.
Social Security, pension, child support, or retirement: the benefit letter or a bank statement showing the direct deposit.
Unemployment: the benefit letter or a bank statement showing deposits.

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You’ll also want your Eversource account number, which is 11 digits and appears on your monthly bill.⁵ If you have both gas and electric service, those are separate numbers, and the form has fields for each.

Filling Out the Form

The form is deliberately short. It asks for your name, address, phone number, Social Security number, gas and electric account numbers, the number of people living in your household, and your total pre-tax income reported as either a monthly or annual figure. There is a financial statement section and a signature line with a date.⁶

Two things trip people up. First, the income figure is the combined pre-tax income of all adults in the household, not just the account holder. Connecticut’s statute defines household income as the combined income over twelve months of the customer and all adults, except the customer’s children, who have lived in the home for six months or more.² Second, the number you write on the form has to match the documents you attach. If your pay stubs show $2,400 a month and the form says $2,000, that gap can stall or sink the application.

Sign and date the form. Your signature authorizes Eversource to verify what you’ve reported.

How to Submit It

Connecticut customers have three options:⁴

Online. Sign in to your Eversource account and upload the form and documents through the document upload portal.
Mail. Send everything to Eversource, Attn: Credit Dept., P.O. Box 270, Hartford, CT 06141.
Fax. 866-438-6476.

A local Community Action Agency can also take the application in person and help you gather documents. If the agency enrolls you in the Connecticut Energy Assistance Program (CEAP) at the same visit, that CEAP approval doubles as your hardship qualification and spares you from documenting income separately.

Massachusetts customers submit through Eversource or a local Community Action Agency. The state regulation requires utility companies to provide hardship forms and instructions on or before November 15 each year, so if you ask in the fall the materials should be ready.⁷

After You Submit

Eversource cross-checks the information on your form against state agency records to confirm eligibility. During that review, an account with a pending hardship application is generally protected from immediate disconnection.

If something is missing, Eversource sends a written notice telling you what to send. Respond quickly. An incomplete application that goes unanswered will eventually be closed, and you’d be starting over. Once approved, a hardship designation is attached to your account, and the shutoff protections set by your state’s rules kick in.

Approval also opens up arrearage forgiveness programs. In Connecticut that’s the New Start Program; in Massachusetts, it’s the Residential Arrearage Management Program (RAMP), which requires income at or below 60 percent of the estimated state median income.⁸ Both forgive a portion of your past-due balance for each on-time payment on your current bill.

Keeping Your Status Active

Hardship protection isn’t permanent, and letting it lapse is the costliest mistake customers make. Once the designation drops off, shutoff protection goes with it, and if you’re in an arrearage forgiveness program, the monthly credits chipping away at your old balance stop.

In Connecticut, the Public Utilities Regulatory Authority says customers may need to submit updated eligibility documentation annually. Contact Eversource for your specific renewal date and the documents required.⁹

Massachusetts runs on a quarterly renewal schedule under 220 CMR 25.03, with one exception: if your hardship is ongoing through the November 15–March 15 winter protection window, quarterly renewal is waived during that period. If you received fuel assistance the previous winter, Eversource must presume you still meet the hardship guidelines and protect your account from November 15 through January 1, giving you time to reapply for the new season.⁷

Reestablishing status after a lapse means a brand-new application with fresh documents.

If You’re Denied

Most denials come down to documentation that didn’t line up with what the form reported. Before escalating, check whether you sent the wrong year’s tax return, left out a household member’s income, or attached an expired benefit letter. A corrected resubmission is usually faster than a formal dispute.

If you believe the denial is wrong, Connecticut customers should try to resolve it with Eversource first, then contact PURA’s Customer Affairs Resolution Center at 1-800-382-4586 (or 860-827-2622 from outside Connecticut) or pura.information@ct.gov, Monday through Friday, 8:30 a.m. to 4:30 p.m.¹⁰ Massachusetts customers can file a complaint with the Department of Public Utilities under 220 CMR 25.03.⁷

1
CT.gov. CT Winter Protection Moratorium
2
Justia. Connecticut Code 16-262c – Termination of Utility Service for Nonpayment, When Prohibited
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Mass.gov. When Am I Protected from Having My Utilities Shut Off?
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Eversource. How to Apply for Financial Hardship in Connecticut
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Eversource. How to Add an Electric or Gas Account
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Eversource. Eversource Financial Hardship Form
7
Cornell Law Institute. 220 CMR 25.03 – Termination of Service to Customers During Financial Hardship
8
Eversource. Massachusetts RAMP Program
9
CT.gov. Payment Assistance Programs
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CT.gov. Filing a Complaint