Perry Township Trustee

Items You Need for Your Emergency Assistance Appointment

Please bring the following information that might apply to your case:

Signature required for ALL household members 18 years and older
Social Security numbers for ALL members of the household
Picture ID or drivers licenses for ALL adults
MUST HAVE signed current copy of your lease/mortgage payment book
Doctor's statement if not working for medical reasons
Proof of citizenship/green card

Proof of income, assets and countable resources for the past 60 days:

Check stubs or letter from your employer
Temporary Assistance for Needy Families Program (TANF) Certificate of Action
Social Security, Supplemental Security Income (SSI) or Veterans Affairs (VA) letter of award
Child support (print out from Clerk's Office)
Statement from anyone that has loaned or given you money
Last year's tax return
Proof of any other income, assets or countable resources

Receipts for Payments (past 60 days)

Rent/house payment
Utilities/telephone/cable
Insurance
Medical bills/medicine
Loans
Child care
Child support
Auto payment
Furniture rental/payment
Back account printout (this is not your bank statement, it is a current (last 30 days) printout you acquire from your bank
Last years taxes
Charge accounts
School fees
Clothing

Information requested pertains to ALL household members

Intake hours by appointment only: 9:00 - 11:00 a.m. & 1:00 - 3:00 p.m.
This information is a guide to what may be required to process your application. This office operates under the Township Assistance Eligibility Standards for Perry Township in addition to the State and Federal laws.

PRINTABLE APPLICATION (PDF)

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