Application for Rent Assistance

  • Application for Rent Assistance

    Required Documents: Photo ID, Monthly Statement or Late Bill, Lease Agreement, Property Owner Form W-9.

  • Rent Assistance Policy

    We require a late rent statement or a monthly bill. Your rent must be past due or due within 48 hours, from today. Must live in CCF Service Area (Sapulpa, Kellyville, Kiefer, East Creek Co). Active Lease must be in your name and current address (or in the name of a current member of your household). Assistance amount up to $250 / per household / per 12 months. CCF does NOT assist with Security Deposits, Initiation/Move-in Fees, First Month Rent, Mortgage Payments, Owner Occupied Homes, Recovery Housing, Properties Owned by Non-Profits, Lease/Rent to Own.
  • This is an application for Emergency Rental Assistance. CCF requires a Late Bill or Monthly Statement. Rent must be late or due within 48 hours from Today - Please do not apply unless / until your Rent is already past due or is due within the next 48 hours. Do you understand that your application will not be approved without meeting this requirement?*
  • Date
     - -
  • Where do you live?*

  • Personal Information

  • What gender do you identify as?
  • What race of ethnicity do you identify as?
  • Format: (000) 000-0000.

  • Household Information

  • Has anyone in your household, including yourself, served on active duty in the U.S. Armed Forces?
  • Is anyone in the household currently receiving SNAP/Food Stamps?
  • Does anyone in your household, including yourself, have a disability?
  • What is your living situation, today?
  • In the last month, did you or anyone in your household work for pay full-time?

  • Documentation

    Please submit a copy of your 1) Federally Recognized Photo ID 2) Lease Agreement 3) Bill or Late notice (showing total amount due) 4) Form W9 for the property owner.  
  • Is the Lease in Your Name and Address, as shown on your Photo ID?*
  • Are you renting a house or apartment?

  • Landlord's Contact Information

    Please include a phone number or email for your landlord.
  • Format: (000) 000-0000.
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  • Do you understand that this agency is only able to assist with up to $250. If your application is approved, you are still responsible for any remaining balance.*
  • I understand that I must submit all of the documents, listed above, to complete my application.*

  • Applications must be complete and include the proper documentation. It generally takes between 1-3 business days for us to process your application. If the application is approved, we will contact your landlord to issue a pledge. Payment will mailed directly to the property owner. 

  • Should be Empty: