Required Documents

If you choose to print off our application, the six links below are required in addition to the supporting documentation listed on the Requirements for Help. Each adult over the age of 18 in the household must sign an Authorization to Release form and a Verification of Eligibility form. 

Instruction Sheet


Requirements for Help

Authorization to Release Information and Records (Each member 18 and older is required to sign one form)

Verification of Eligibility for State and Local Information and Records

Household Expense Form (sometimes referred to as a "Green Sheet" in our office)

Assistance Application

  • Call (260) 485-5993 to request an application packet. Once the packet is requested, it may be picked up at the Township Assistance Office at door 12 or mailed to you. If you choose, you may also print off all of the documents listed above.
  • Follow the instruction sheet included in the application packet. Collect ALL the items on the Requirements for Help form. This applies to every single adult in the household, age 18 and older. Be aware that missing documents slows down the application process. All adults 18 and older must fill out the Household Expense Form and sign the Authorization to Release Information and Records form and the Verification of Eligibility for State and Local Public Benefit form. All forms are included in the packet, and links to all forms are listed above. 
  • Bring the completed application, Requirements for Help items, the signed forms, and the completed Household Expense Form to the Township Assistance office. Applications CANNOT be processed without the supporting documents. Applications can be dropped off through the mail slot at door 12. This is not a Postal Service mail slot and does NOT require postage. Do not include your original driver's license, social security card, and birth certificate if you are dropping the packet off through the mail slot. If you drop your application off outside of normal business hours, it will be processed the next business day.
  • The township office offers free copy service of documents needed during normal business hours. Bring your documents in during our business hours and call us to let us know that you need copies made for your application. Clear, legible copies can can also be emailed to Please make sure to email the entire page. 
  • Once the application has been turned in with all required documents and signatures, it will be entered into our system, and an investigator will review your application and paperwork. Applications are processed in the order in which they are received. Once the investigator receives and reviews your paperwork, the investigator will call and explain the township assistance process. The investigator will also ask any questions they may have to proceed with your case. You will also have the opportunity to ask any questions you may have. If the investigator needs additional information, you will be informed of this and you will be given a deadline in which the information needs to be provided by.
  • By law, the investigator has 72 office hours to complete your case, which equates to 1 week. In most cases, a determination will not be made the same day the application is submitted.
  • Please remember, the application process is the same regardless of disconnects and/or evictions. Do not wait until the day of disconnect or the day of an eviction notice to apply for assistance. 
  • Once your case is complete, the investigator will call you to inform you if you qualify for assistance. If you qualify for assistance, you will also be informed as to the amount of assistance that you qualify for. The investigator will complete an action letter, which will explain the townships decision, and provide a copy for you. The investigator may also give referrals, if necessary, to other agencies, and/or provide you with other helpful information.
  • There is no cash or check payment made directly to you. Payment is made to the vendor for your benefit. You will be informed of any outstanding amounts that are still owed. 
  • If you have any questions, please call the Township Assistance office at (260) 485-5993.
  • Township guidelines are available on this website.