Cash help when you are in need

For the household, any one document:

One of these:

• Statement from landlord or primary tenant
• Current rent receipt or lease
• Mortgage records

If you don’t have one of the above list, bring two of these:

• Statement from another person
• Current mail
• School records

For each source of each income earner, any one document:

Wages & Salary

• W-2 form
• Income tax return
• Letter from employer on company letterhead, signed and dated
• Paycheck stubs (1 stub of earnings to date, 1 stub if you are paid monthly, 2 stubs if you’re paid a few times a month, or 4 stubs if you are paid every week)

Self-employment

• Signed and dated income tax return and all schedules

Military pay

• Leave and Earnings Statement (LES)

Severance Pay

• Self-declaration from the participant

Unemployment Income

• Award letter or certificate
• Current benefit check

Social Security Benefits (SSI, Dependent, Disability, Survivor’s, Retirement)

• Current award letter or certificate

Veteran’s Benefits

• Current award letter

Education Grants and Loans

• Statement from school, statement from bank, or statement from agency administering grant or award letter

Interest, Dividends, Royalties

• Statement from bank, credit union or financial institution
• Statement from broker or agent

For each expense, any one document:

Shelter Expenses

• Current rent receipt, lease, mortgage book, or records
• Property and school tax records
• Landlord statement
• Sewer and water bills, or garbage or trash collection bills or receipts
• Homeowner’s insurance records
• Fuel bills or fuel shut-off notice
• Non-heating utility bills
• Telephone bills (or a statement from the household that the expense is incurred)

Medical Expenses 

• Statement from provider of health insurance premiums
• Copies of medical bills (paid and unpaid)
• Medicare prescription drug card

Other Expenses or Dependent Care Cost

• Court order
• Statement from day care center or other child care provider
• Statement from aide or attendant
• Canceled checks or receipts

For each person applying, any one document:

• Birth certificate
• Baptismal certificate or records
• Hospital records
• U.S. passport
• Military service records
• Naturalization certificate
• USCIS documentation
• Evidence of continuous U.S. residence since before 1/1/72

For each person applying, any one document:

• Marriage or death certificates
• Separation agreement
• Divorce decree

For each person applying, any one document:

• Birth certificate (long form)
• Adoption papers or records
• Court records
• Medical records

For the household, any one document:

• Statement from non-relative landlord
• School records

For each absent family member, any one document:

• Death certificate
• Survivor’s benefit records
• Hospital records
• VA or military records
• Divorce papers
• Proof of remarriage

For each parent, any one document:

• Pay stubs
• Tax returns
• Social Security or VA records
• Monetary determination letters
• I.D. cards (health insurance)
• Driver’s license or registration

For each resource of each resource holder, any one document:

• Current bank and credit card records
• Stock or bond certificate and statement from financial institution for stocks, bonds, certificates and mutual funds
• Insurance policy and statement from insurance company for life insurance resources
• Burial agreement and burial plot deed for burial trust or fund
• Refund of EITC check and statement from tax office for income tax or EITC
• Deed statement from real estate broker and broker’s estimate of current value (for real estate other than residence)
• Vehicle registration, title of ownership, and appraisal of current value by dealer, and financing data for motor vehicles
• For lump sum payment, statement from the source of payment and lump sum check
• For all other resources, statement from household, statement from nursing home, or household statement of current value and sales slips

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