Assistance Application
Financial Assistance
Please complete this application AND attach proof of income for all adults in your household. If you do not have any of these documents, contact HFW at 260-744-0454 for clarification. Applicants must be residents of Allen County to be eligible for financial assistance.
Approval of Assistance Applications can take up to 10 business days. Applications are valid for 30 days from approval date. One approved application per household per year.
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Acceptable Forms of Proof of Income
To complete the review of an application for financial assistance, clients must provide proof of income for all adults residing in their household. Examples of acceptable documentation include:
For Employed Individuals:
- Recent pay stubs
- A signed letter on company letterhead detailing their rate of pay and average hours
For Self-Employed Individuals:
- The most recent federal tax return (e.g. Schedule C)
- Completed FSSA Report of Self-Employment Income forms or business logs
For Unemployed Individuals:
- A statement or printout showing your weekly benefit amount from Indiana Unemployment (DWD)
For Other / Fixed Income:
- Official award letters for Social Security (SSA), Supplemental Security Income (SSI), VA benefits, or child support documentation
