Application: Rent, Utilities, Food
Individuals requesting county funding must complete the General Assistance Application and supply the supporting documentation. This information can be found below. Please call for more information or if you have any questions.
Additional Documents
- Landlord Verification Form
- Employer Statement of Earnings Form
- Self-Employment Income Statement Form
- Incapacity to Work Form
- Job Search Verification Form
Required Verification
The following required verification must be submitted with your application. Applications will be reviewed when all required documents are received by the General Assistance Office.
Some of the documents listed below may not apply to your particular situation. Please call for more information or if you have any questions.
- Identification
- Photo ID or driver's license of applicant(s)
- Social Security number for each member living in the immediate household
- Statements, current month showing transactions to date and one full month prior for all:
- Checking accounts
- Savings accounts
- Direct express account transactions
- Wisely account transactions (Sec, 8 utility allowance)
- Any P2P account including Cash App or any equivalent
- Written proof of household gross income for prior eight weeks, including but not limited to:
-
- Employment wages (pay stubs or employer statement of earnings form)
- Social Security (SSI, SSDI)
- Child support
- Alimony
- FIP
- SNAP
- Section 8 Housing allowances
- Pension
- Unemployment
- Worker’s compensation
- Money provided by family or friends.
- Other "odd jobs for cash” require submission of self-employment income statement form
- Self-employed, last year's tax return is required and income received eight weeks prior to application date using the self-employment income statement form
- If not currently employed
- Job Search Verification Form is required
- Proof you are registered with the nearest staffing agency
- Proof you are registered with Iowa Workforce Development
- If you are disabled (permanently or temporarily) Incapacity to Work Form is required
- If applying for utilities: *Jackson County does not assist with utility deposits or re-connect fees
- Disconnect notice
- Most recent utility bill
- If applying for rent: *Rent cannot be paid to relatives ** ackson County does not assit with rental depoits, first or last month rent
- Eviction notice
- Lease
- Landlord Verification Form
