Human Services provides a variety of assistance programs, each with unique eligibility criteria and required documentation. Dependent upon the type of assistance you may be seeking, please open a document to learn about eligibility and documentation requirements. Eligibility and documentation requirements are the same throughout all offices.
Energy requirements: This document exhibits information for persons seeking assistance with their home energy (electric, gas, or propane) expenses.
Water requirements: This documents exhibits information for persons seeking assistance with their water expenses.
Housing requirements: This document exhibits information for persons who have an eviction notice, past-due mortgage statement, or are in need of rental deposit assistance.
Dental requirements: This document exhibits information for persons without any form of dental insurance and may be in the need for an emergency tooth extraction.
Prescription requirements: This document exhibits information for persons without any form of health insurance and may be in the need for life-sensitive medication.
Supplemental eligibility form
These are commonly used forms applicants must complete or present for assistance. Depending on your situation and the type of assistance you are seeking, the forms needed will vary. Please review the explanation of each document carefully to determine if you or someone in your household may need to complete it or contact an office for further guidance.
Application: This is the standard Human Services application that must be completed for each requested service. The application provides enough to collect information for a household of 10 people.
Self-declaration of income: This document may be used for any adults in the household who 1) have not had any form of income within the previous 30 days or 2) have received undocumented income within the previous 30 days.
Employment verification: This document may be used to verify previous employment or current employment in circumstances which the employee did not receive proof of payment.
Persons in household: This document may be used to provide information regarding additional persons, both adults and children, who reside in the household but are not listed on the lease, mortgage statement, or property tax statement.
Persons no longer in household: This document may be used if a person’s name is on the lease, mortgage statement, or property tax statement but for whatever reason is no longer residing in the household. In addition to this form, the person applying for assistance must have a valid Florida Driver’s License with this address and the utility bill must be in their name.
Note: LIHEAP and EHEAP applications will be provided by staff to applicants arriving for an appointment or walk-in seeking an appointment. These applications must be completed on-site on the day of meeting with a case worker.