Apply
For Help

Full Name

Date of Birth

Your Gender

Marital Status

Your Ethnicity

Your Race

Mobile or Home Phone

Work Phone

Disabling Conditions

Message

Family Name / Head of Household

Your relationship to head of household

Number of Adults in Household

Number of Children in Household

Full Name

Emergency Contact Home Phone

Emergency Contact Office / Cell Phone

Current Housing Status

Have you received rental or mortgage assistance within the last year?

How much is your base monthly rent or mortgage payment?

Are you current on your rent or mortgage payments?

If you answered no, for which months do you owe?

Employment Status

Employment Benefits

Veteran Status

Have you received income from any source in the past 30 days?

Have you received non-cash benefits from any source in the past 30 days?

IDENTIFICATION

To qualify for assistance you must have two forms of identification. TAG can accept:

First Identification Document

Second Identification Document

Utility (water, electricity, gas, cable) bill dated within 30 days

PROOF OF INCOME

You must provide proof of Proof of household income for the past 45 days. TAG can accept:

Proof of Income

Additional Income Documentation

CRISIS DOCUMENTATION

You must provide proof of hardship or documentation of crisis. Proof of loss must be within 30 days.TAG can accept:

Crisis Documentation

Additional Crisis Documentation

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