What to Bring

 

All adults (persons 18 years of age or older) in the household and/or on the lease must attend the appointment to sign the application in the presence of a case investigator.

Clients must provide all documentation at the time of appointment or the application will not be accepted. PLEASE DO NOT SIGN THE APPLICATION.

DOCUMENTATION AND INFORMATION NEEDED, BUT NOT LIMITED TO:

 

Picture identification card for all adults in the households

  • Indiana Drivers License

  • Indiana Identification Card

  • Birth Certificate

Social Security Cards for all members of the household

Proof of all household income for the specified time periods, including but not limited to:

Income that must be provided for the 30 day period prior to the appointment:

  • Payroll gross income (must provide all check stubs received during this period)

  • Social Security Income or SSI

  • Temporary Assistance for Needy Families (TANF)

  • Child Support (must provide all check stubs or current printout from child support office for this period)

  • Gifts, Loans, etc. (must provide a statement from the source of this type of income)

  • Money acquired from selling plasma, personal items, property, etc.

  • Unemployment checks (must provide all check stubs or current printout from Workforce Development for this period)

  • Workmen’s Compensation Settlements or Checks (must provide all check stubs received during this period)

  • Retirement and/or Pension checks

  • Veteran’s benefits

  • Trusts

  • Income from any other source received by the applicant and/or household members

Income that must be provided for the 120 day period prior to the appointment:

  • Income Tax Returns or Documentation of Filing Status (copies of your 10-40 & IT-40 even if your refund was taken to repay taxes or some other debt)

  • Student aid refunds

  • Any other type of lump sum income received by the applicant

If you are requesting assistance with any bill that was incurred more than 60 days ago, you must provide proof of income/expenses for the period in which the bill was incurred.

  • A current lease and/or current utility bill(s) that you are applying for assistance with. These must be in the name of an adult household member.

 

See reverse side for other documentation you may be required to provide at your appointment.

Failure to provide any of this information with your application will be considered failure to cooperate and your application may be denied. If you are going to be more than 10 minutes late you must call our office at 336-3713. If you need to have any documents faxed to our office, the fax number is 332-6406.

Other information that may be required for your appointment:

  • Have you received any type of cash payments (for wages, child support, gifts, loans, etc.)?
    You must provide our office with a statement from the person or company who paid you in cash verifying the amount you received in the 30 days prior to your appointment.

  • Have you applied for employment recently?
    You must provide our office with information (name, location, phone number) for establishments where you recently applied for employment.

  • Are you unable to work due to illness or injury?
    You must provide a current doctor’s statement verifying your inability to work.

  • Have you applied for SSI or Disability benefits through the Social Security office?
    You must provide a current statement from the Social Security office verifying the date of your application and the status (i.e. initial, reconsideration, appeal) of your claim(s).

  • Has child support been ordered for your child or have you filed for child support and are awaiting a court hearing?
    You must provide either verification of your child support order(s) or verification of the status of your child support claim(s).

  • Are you receiving benefits from the Division of Family Resources?
    You must provide verification of the benefits you are receiving (Food Stamps, TANF, Medicaid).

  • Are you receiving HUD or Section 8 Housing?
    You must provide verification of your HUD or Section 8 Housing benefit from the Bloomington Housing Authority, SCCAP office, Henderson Court, or other agency.

  • Are you a college student?
    You must provide verification of your student status, and verification of student aid refunds you received (in the last 120 days) or will be receiving in the future.

  • Have you spent a large sum of money ($250+) on something other than rent or utilities?
    You must provide receipts for large expenses such as car repair, car payment, furniture, electronics, appliances, etc.

  • Are you requesting assistance with prescription medications or a doctor visit?
    If you need assistance with prescription medications you must provide either written prescriptions or medication bottles from the pharmacy showing that refills are available for the medication you require.
    If you need assistance with a doctor visit of any type you must provide a statement from the doctor you intend to visit stating the reason for and cost of your visit.

  • Do you need help with rent, but you have not signed a lease with your landlord?
    You must provide a statement from your landlord verifying your address, names of household members, and monthly rent amount. This statement must be signed by your landlord and must include your landlord’s contact information.

If there is any other documentation that you feel is relevant to your request for Township assistance, please bring it to your scheduled appointment.

2-page printable "What to Bring" info

 
 

hours

Assistance hours: Mon-Fri, 9am - 3pm

Pantry Hours: Mon-Fri 9am-2:45pm

Phone hours: Mon-Fri, 8am - 4pm

 

 

 

web counter
web counter

 

contact

Perry Township 812-336-3713
1010 S. Walnut St. PerryTownship.info
Bloomington, IN
47401

 

 

For the Emergency Assistance Program: This email address is being protected from spambots. You need JavaScript enabled to view it.

 

For other inquiries:                                                  This email address is being protected from spambots. You need JavaScript enabled to view it.

 

 

 

 

 

 

 

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