Online Rent & Utility Assistance Request Form
Our weekly rent & utility assistance screening form for families with children under the age of 18 or seniors age 55 or older living in Oklahoma County is open on Monday mornings at 7:00 a.m. via our website until the number of requests received exceeds our funding capacity for the week. We do not accept requests during weeks with a holiday.
Required Documentation
Please note, some programs may require additional documentation. After completing our initial screening, your case manager will confirm the required documents.
- Completed agency application.
- Signed authorizations for release of information for property owner/manager.
- Signed authorizations for release of information for utility provider(s).
- Copy of driver’s license or state identification card and Social Security cards for adult family members.
- Copy of Social Security cards or other verification of Social Security numbers for children (DHS printout, tax return, etc.).
- Documentation of Income or Pending Income Verification
- Copy of lease if requesting rent assistance.
- Copy of eviction notice or 5-day notice to quit.
- Copy of utility bill(s) with cutoff notice if requesting assistance with utility bill(s).
- Proof of hardship that has caused the difficulty in paying the bill. Loss of income after March 1, 2020 qualifies as a hardship.
- Completed property owner/manager verification form.
- Completed W-9 from the property owner/manager.