COVID-19 EMERGENCY FINANCIAL ASSISTANCE
For rent, mortgage, childcare, utilities or burial costs due to COVID-19
Please read all instructions on the website before applying. Thank you.
Date of Birth
Social Security #
Street Address Line 2
State / Province
Postal / Zip Code
Please enter a valid phone number.
Please select which type of assistance you are requesting:
Please describe your loss of income and current financial situation as well as the date of income loss.
I have/have not received any CARES ACT funding in the past 3 months:
I certify that the information included on this application is true and correct and that I am eligible for emergency assistance from the City of Manassas.
Should be Empty: