Utility and Rental Assistance

Rental/Utility Assistance Eligible Debts-

-Rent or Mortgage

-Electricity

-Water or Sewer

-Oil or Gas

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* 1. The application does take 5-7 days to review.
If you have a turn-off notice that needs to be paid immediately, please seek assistance from another agency.
We DO NOT have funding to give financial assistance for the following reoccurring debts: Credit cards, mobile phone service, cable or any other entertainment services, internet, any type of insurance, car note, homeowners association dues, medical or dental services, or home repairs.
Prior to your application/ request being reviewed, you must provide all documentation requested. If you are missing any documentation we will have to move to the next applicant, and you will have to restart the process. THE INCOME SUBMITTED MUST BE ABLE TO SUSTAIN YOUR FUTURE EXPENSES. Please select "Yes" if you understand these regulations and requirements.

Yes, I understand

No, I do not understand

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* 2. To qualify for assistance, you must answer "yes" to one of the questions below and your debt must not be older than 90 days late.
If you have been hospitalized or if you have another legitimate reason why your debt is older than 90 days, please include a written statement explaining why your debt is older than 90 days.

Also, if you do answer "yes" to any of the questions below you will need to provide proof.
Please select which of these statements you answer yes to.

You have become unemployed within the last 90 days.

You have suffered a recent illness that has caused you to lose your job or caused you to miss a lot of time from your job.

You have suffered a loss of income in the past 90 days due to a death.

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* 3. Please explain why you need assistance.

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* 4. Please type your name if you have read, and understand the information above.

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* 5. Please check the box after you have read and understand the statement.

I understand that Community Reach Inc will verify any information and/or documentation that I have provided to them.

I understand that I must have all information and documentation that is listed in the assistance package when submitting the package.

I understand that if any information or documentation is missing from my assistance package it will automatically be rejected. If rejected, I will have to resubmit my package once it is completed.

I understand that if my application is approved, I will NOT be eligible for further rental or utility assistance in the future. This program can't be used in the same household more than ONE TIME.

I understand that it is my responsibility to pay any disconnection or reconnection fees. The agency may require me to pay a portion of the debt depending on my financial situation.

I understand that any payment arrangements made with the debtor must be made by me. The agency will not discuss payment options with the debtor or contact them on your behalf. The agency will only contact the debtor to verify the debt.

I understand that for my assistance package to be reviewed I must provide all the information and documentation that Community Reach has requested on the application and documentation list.

I understand that if my assistance package is missing any information or documentation, my application will be automatically rejected. Community Reach will move to the next applicant.

I understand that if my assistance package is rejected, I can resubmit my assistance package one completed, and it will be reviewed in the order my completed assistance package was received.

I understand that resubmitting my assistance package doesn't guarantee that Community Reach will still have funding for this program at that time.

I agree that any/all information that I provide to Community Reach is true and accurate.

I acknowledge that if it is found that I misrepresented my household information or any other information that I provide to Community Reach I am no longer welcome to participate in any of Community Reach's other programs.

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* 6. DOCUMENTATION MUST BE SUBMITTED OR UPLOADED PRIOR TO REVIEWING YOUR APPLICATION. (If you do not submit all of the required documents your application will be denied without being reviewed.) Please check yes if you understand.

Yes, I understand

No, I don't understand