There are two forms available for energy suppliers for the Low Income Energy Assistance Program (LIEAP). The Vendor Claim Form is an online submission form. You no longer need to mail in claims, as once the online form is completed, the claim will automatically be submitted.
However, you will still need to fill out and mail the Direct Deposit Enrollment Form.
- Vendor Claim Online Form - Form used to submit claims.
- Instructions on the Vendor Claim Form:
- Type in your Vendor ID and Password.
- Click on either List View or Search.
- List View displays the entire list while Search allows you to limit the display on List View.
- List View allows you to Click on Case Number which opens the Claim Submission page.
- Claim Submission is for entry of your claim data.
- Delivery/Meter Read Date: This is the delivery date OR the meter read date. A valid date must be entered.
- Number of Units: Enter gallons / cubic feet / kWh. A number must be entered.
- Unit Price: Enter price per gallon / cubic feet kWh. Unit Price needs to be in a number with the decimal.
- Billing Amount: This is the cost of the number of units multiplied by the unit price plus sales tax. Billing Amount needs to be in a number with the decimal.
- Click on the Submit Button to Submit your Claim.
- The Claim will automatically be sent to the Office of Energy Assistance in Pierre.
- Vendor Claim Print Form - Form to be filled out and mailed in (temporarily) if you are unable to use and submit the online form above.
- Direct Deposit Enrollment Form - Form to enroll in direct deposit of payments.
- Mail the completed Direct Deposit form to the following address:
- South Dakota Department of Social Services
Office of Energy Assistance
910 East Sioux Ave.
Pierre, SD 57501
- Call 1-800-233-8503 if you have questions.