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 household. Examples include:
- 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:
- 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 Settlement or Checks (must provide all check stubs received during this period)
- Retirement and/or Pension checks
- Veteran's benefits
- 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.
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 (812) 336-3713. If you need to have any documents faxed to our office, the fax number is (812) 332-6406.
Additional Information to Bring
If you have 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.
If you have applied for employment recently, you must provide our office with information (name, location, and phone number) to establish where you recently applied for employment.
If you are unable to work due to illness or injury, you must provide a current doctor's statement verifying your inability to work.
If 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, etc.) of your claims.
If child support has been ordered for your child or you have 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).
If you are currently receiving benefits from the Division of Family Resources, you must provide verification of the benefits you are receiving (Food Stamps, TANF, Medicaid, etc.)
If you are 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.
If you are a college student, you must provide verification of your student status, as well as verification of student aid refunds you received (in the last 120 days) or will be receiving in the future.
If you have spent a large sum of money ($250+) on something other than rent or utilities, you must provide receipts for large expenses (i.e. car repair, car payment, furniture, electronics, appliances, etc.)
If you are requesting 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 are requesting 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.
If 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, the names of household members, and the 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 Perry Township assistance, please bring it to your scheduled appointment. If you have questions or would like to contact our investigators about the required documents necessary to recieve assistance, you can email them at: