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
After you apply for assistance
Please Copy and send the necessary items listed herein by Registered Mail To:
ApplicationP. O. Box 93Jackson, TN. 38302
Name
Assistance
Account(s)
Living Status
Bill(s)
Do you receve | SNAP | Families First | WIC
Rehabilitation Center 6mos or more
I authorize Chaplain Jeffery G Douglas to perform the necessary procedures
By Sumbitting this form: You authorize Chaplain Jeffery G Douglas to perform the necessary procedures including Third Party Assistant Submission under section 25. Third Party Services on your part and have Read, Understand, and Agree to All Terms & Conditions set forth herein including 27. Electronic Signature Agreement and 28. Signing & Submitting Application
There is only ONE who knows when this World Will End, is "God."  -- by -- Jeffery G. Douglas
Share with Friends & Family
Copyright © All rights reserved.

December 01, 2023 - 6:48 AM - CST