Application For Assistance
You are required to send:
Proof of all household income (Last Pay Stub, Return, or Affidavit) 1. Lease or Proof of Residence2. Copy of all bills you're requesting help with3. You may be required to send:
Photo ID’s for adults in the home Social Security Cards for everyone in the home Birth Certificates for children in the home
Photo ID’s for adults in the home Social Security Cards for everyone in the home Birth Certificates for children in the home
After you apply for assistance
Please Copy and send the necessary items listed herein by Registered Mail To:
ApplicationP. O. Box 93Jackson, TN. 38302
By Sumbitting this form: You authorize Chaplain Jeffery G Douglas to perform the necessary procedures including Third Party Assistant Submission under section Third Party Services on your part and have Read, Understand, and Agree to All Terms & Conditions set forth herein including Electronic Signature Agreement and Signing & Submitting Application
Assistance Eligibility Information
The following describes considerations for eligibility:
1. Residency Applicants must be living in the State of Tennessee or United States Territory to receive benefits. 2. Age and Relationship You must be of Legal Age as defined by your state to receive benefits. Parents and their children 21 years old or younger living together, and Individuals living together who share expenses together, are considered one household. Person Thirteen (13) years of age to Seventeen (17) years of age appling on their own, must be living without their parents with Proof of emancipated minor requirement. 3. Citizenship An applicant must be a U.S. citizen to qualified for benefits and To be eligible, all household members must have a valued social security number or proof of having applied for one
4. Work To receive benefits, most able-bodied people starting at Sixteen(16) years of age must register for work, participate in the Employment & Training Program if offered, accept offers of employment, and cannot quit a job. Applicant may be required to show proof of employment and training program. Able-bodied adults without dependents aged Eighteen (18) years of age to Twenty (20) years of age may receive limited benefit for 1 year, unless working 80 hours per month or otherwise determined exempt from the rule.
5. Other Factors Strikers are not eligibile for benenfits.
Most college students must be working an average of 20 hours per week, enrolled in work-study, caring for young dependents, or receiving Families First.
Felons convicted of certain drug-related offenses are not eligible benefits.
Individuals disqualified for fraud are ineligible for one year for the first offense, two years for the second offense, and permanently for the third.
Dependents of disqualified or ineligible individuals may be eligible. 6. Resource Test
The asset limit is $2,750 for most households and $4,250 for households containing a member who is disabled or 60 years of age. Assets not counted are the home the applicant is presently living in and its lot, household goods, income producing property, real estate that is up for sale, cash value of life insurance, personal property, retirement accounts such as IRA and 401k plans, and vehicles with equity value under $1,500.
Other vehicles not counted are those used for family transportation, to go to and from work, to produce income, for subsistence hunting and fishing, as the household’s home, to transport a disabled household member, and to carry the household’s primary source of heating fuel or water.
Countable assets include cash on hand, money in checking, savings accounts, certificates of deposit, stocks, bonds, property not up for sale, and lump-sum payments.
7. Income Tests The program does not count scholarships, grants and loans used for tuition and fees, reimbursements, heating assistance, earnings of children age 17 and younger who are in school and most loans. Countable income may include but is not limited to such things as: employment, self-employment, alimony, child support, disability benefits, Social Security/SSI, Worker’s Compensation, Unemployment benefits, pensions, stipends, and interest income. Households which contain an elderly or disabled member do not have to pass the gross income standards but are subject to the net income standards.
8. Deductions The Program rules allow income deductions, including a 20% deduction on earnings, a standard deduction given to all households, dependent care expenses incurred, a shelter/utility deduction for a non-special household not to exceed $624, and medical expenses over $35 for elderly or disabled household members.
9. Assistance Eligibility Benefits This benefit is to help individual and is "One-Time Only" and "Non-Reoccurring Benefit. You may apply again, however, it is no guarantee you will receive additional help.
10. Third-Party Submission By Electrically Signing the Ap·pli·ca·tion, You have agreed to allow Chaplain Jeffery G. Douglas to submit your information to other Providers in which you may el·i·gi·ble for through that Provider.
In Addititon, you agree and in·here and hold harmless Jeffery G. Douglas for the following; 1. You are responible for following through their ap·pli·ca·tion re·quire·ments 2. That you may be turned down by that Provider under their guidelines 3. The Third-Party Submission "Stands Alone" and not in any Form or Fashion as·so·ci·at·ed with this service
1. Residency Applicants must be living in the State of Tennessee or United States Territory to receive benefits. 2. Age and Relationship You must be of Legal Age as defined by your state to receive benefits. Parents and their children 21 years old or younger living together, and Individuals living together who share expenses together, are considered one household. Person Thirteen (13) years of age to Seventeen (17) years of age appling on their own, must be living without their parents with Proof of emancipated minor requirement. 3. Citizenship An applicant must be a U.S. citizen to qualified for benefits and To be eligible, all household members must have a valued social security number or proof of having applied for one
4. Work To receive benefits, most able-bodied people starting at Sixteen(16) years of age must register for work, participate in the Employment & Training Program if offered, accept offers of employment, and cannot quit a job. Applicant may be required to show proof of employment and training program. Able-bodied adults without dependents aged Eighteen (18) years of age to Twenty (20) years of age may receive limited benefit for 1 year, unless working 80 hours per month or otherwise determined exempt from the rule.
5. Other Factors Strikers are not eligibile for benenfits.
Most college students must be working an average of 20 hours per week, enrolled in work-study, caring for young dependents, or receiving Families First.
Felons convicted of certain drug-related offenses are not eligible benefits.
Individuals disqualified for fraud are ineligible for one year for the first offense, two years for the second offense, and permanently for the third.
Dependents of disqualified or ineligible individuals may be eligible. 6. Resource Test
The asset limit is $2,750 for most households and $4,250 for households containing a member who is disabled or 60 years of age. Assets not counted are the home the applicant is presently living in and its lot, household goods, income producing property, real estate that is up for sale, cash value of life insurance, personal property, retirement accounts such as IRA and 401k plans, and vehicles with equity value under $1,500.
Other vehicles not counted are those used for family transportation, to go to and from work, to produce income, for subsistence hunting and fishing, as the household’s home, to transport a disabled household member, and to carry the household’s primary source of heating fuel or water.
Countable assets include cash on hand, money in checking, savings accounts, certificates of deposit, stocks, bonds, property not up for sale, and lump-sum payments.
7. Income Tests The program does not count scholarships, grants and loans used for tuition and fees, reimbursements, heating assistance, earnings of children age 17 and younger who are in school and most loans. Countable income may include but is not limited to such things as: employment, self-employment, alimony, child support, disability benefits, Social Security/SSI, Worker’s Compensation, Unemployment benefits, pensions, stipends, and interest income. Households which contain an elderly or disabled member do not have to pass the gross income standards but are subject to the net income standards.
8. Deductions The Program rules allow income deductions, including a 20% deduction on earnings, a standard deduction given to all households, dependent care expenses incurred, a shelter/utility deduction for a non-special household not to exceed $624, and medical expenses over $35 for elderly or disabled household members.
9. Assistance Eligibility Benefits This benefit is to help individual and is "One-Time Only" and "Non-Reoccurring Benefit. You may apply again, however, it is no guarantee you will receive additional help.
10. Third-Party Submission By Electrically Signing the Ap·pli·ca·tion, You have agreed to allow Chaplain Jeffery G. Douglas to submit your information to other Providers in which you may el·i·gi·ble for through that Provider.
In Addititon, you agree and in·here and hold harmless Jeffery G. Douglas for the following; 1. You are responible for following through their ap·pli·ca·tion re·quire·ments 2. That you may be turned down by that Provider under their guidelines 3. The Third-Party Submission "Stands Alone" and not in any Form or Fashion as·so·ci·at·ed with this service