Nambe Pueblo Housing Entity

Free home energy efficiency retrofits for income-qualified households on Nambé Pueblo, funded by NM EMNRD/ECAM. Assistance is subject to eligibility, a home energy assessment, and available funding. Fields marked * are required.

Applicant Information

Full Name *

Date of Birth *

Tribal Enrollment / Census # *

Tribe / Pueblo *

Phone *

Email Address

Home Information

Physical Address (home receiving services) *

Mailing Address (if different)

Electric Utility *

Avg. Monthly Electric Bill ($)

This Home Is *

Primary, Year-Round Residence *

On Nambé Pueblo Land *

Main Energy Concerns

Check all that apply.

Other Concerns / Additional Notes

Household

People Living in the Home *

Tribal Members in Household *

Income Qualification

Enter the adjusted gross income (AGI) from your federal tax return (Form 1040, line 11). Include income of all household members. For members who do not file taxes, add their gross income from all sources (wages, Social Security/SSI, pension, unemployment, TANF, child support, etc.).

Total Annual Household AGI ($) *

200% Federal Poverty Level Limit

—

Enter income to verify

1 person	2 persons	3 persons	4 persons	5 persons	6 persons	7 persons	8 persons
$31,920	$43,280	$54,640	$66,000	$77,360	$88,720	$100,080	$111,440

CEED Program eligibility standard — 2026 HHS Poverty Guidelines at 200% FPL. Households larger than 8: add $11,360 per additional person. NPHE applies the guidelines in effect when your application is reviewed.

Additional Questions

Does any household member have a disability or medical condition affected by home temperature? *

Any household member age 60+? *

Currently receiving LIHEAP / weatherization? *

Review Your Application

Certification & Consent

I certify that the information on this application is true and complete. I authorize NPHE to verify income, enrollment, utility, and occupancy information to determine eligibility, and to share required information with NM EMNRD/ECAM for CEED Program reporting and monitoring. I grant NPHE staff, energy assessors, and approved contractors permission to enter the home at scheduled times for energy assessments and approved work. I understand false information may result in denial of services, and that this application does not guarantee assistance.

I have read and agree to the certification above *

Electronic Signature — Full Legal Name *

Date *

CEED Program Application — Community Energy Efficiency Development

Application Submitted Successfully

Application

Application Submitted Successfully

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