Client Forms

Weatherization Program:

Our forms are provided to our clients in this section.  If you do not see what you are looking for, check in our programs section or  contact: Darlene Simms at her email
dsimms@uccac.com or call: 845-338-8750, ext. 120.

Weatherization Application – Homeowners

Application and Forms are currently being updated. Please call for an application. We apologize for any inconvenience.

  1. Cover Sheet
  2. DHCR#4 –Weatherization Application
  3. DHCR#5A – Energy Information
  4. DHCR#3 – Personal Privacy Protection Form
  5. Weatherization Partnership Agreement
  6. Client Information Sheet – House
  7. Client Information Sheet – Mobile Home
  8. NYSERDA/Empower Application

* Renters along with Landlords need to call the office for information and applications.


* Group Homes and Shelters need to call the office for approval.