CHN Housing Partners' Invoice Submission Form
Upon submission of this form, your information will be automatically routed to the billing specialist responsible for the related program.
Business Name (as it appears on the invoice)
Business Contact (the person completing this form)
Business Email (Sends Copy of Submission)
What Program are you submitting this invoice for?
Please select...
HWAP (Warm Choice)
BIL
Housewarming
Plumbing Program
CEI (CPP)
EPP
Type of Job
CHN Only
Agency Collaboration
Bill / HWAP Collaboration
What job type are you submitting this invoice for?
Please select...
HVAC
Plumbing
WX
Roofing
Electrical
Client Name
Job Number
Work Completed Date
Invoice Amount
Invoice Number (
Must be a unique number, no repeats per invoice
)
Number of Invoices Submitted
Is this a revision?
Yes
No
Is this a Q/C Callback
Yes
No
Click the '
Add Another Upload Here
' to add multiple invoice attachments
Upload your invoice here:
Edit section title
Program Email
Contact Information