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Catholic Charities Paterson
Help Application
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Today's Date
-
Month
-
Day
Year
Date
Street Address
Street Address 2
City
State
Please Select
New Jersey
Other
Zip Code
What county in NJ do you reside in?
Please Select
Morris
Passaic
Sussex
What type of assistance do you need in Passaic County?
Please Select
Food Pantry
Rental - Passaic
Utilities
Homeless
Thrift Store
Senior Services
Youth
Legal
Preschools
Other
What type of assistance do you need in Morris County
Please Select
Food Pantry
Rental - Morris
Veterans
HIV
Senior Services
Other
What type of assistance do you need in Sussex
Please Select
Food Pantry
Thrift Store
Meals on Wheels
Other
If you answered yes to homeless, please select housing situation
Please Select
Homeless shelter
Hotel
Street
Car
Other
Are you behind on rent?
Yes
No
Are you receiving any government housing?
Yes
No
Are you receiving SSI or welfare benefits?
Yes
No
Can you demonstrate/show why you couldn't pay your rent?
Yes
No
Do you have a courts summons?
Yes
No
Do you have an eviction or lockout?
Yes
No
What is your monthly rent?
Have you lost income due to COVID (furloughed, reduced hours, laid off)?
Yes
No
Do you have unemployment or laid off letter?
Yes
No
Do you live in the city of Paterson?
Yes
No
Are you behind on rent?
Yes
No
Are you receiving government housing?
Yes
No
Are you receiving SSI or welfare benefits?
Yes
No
Can you demonstrate/show why you couldn't pay your rent?
Yes
No
Do you have a court summons?
Yes
No
Do you have an eviction or lockout?
Yes
No
What is your monthly rent?
Upload Hardship Documents
Browse Files
Drag and drop files here
Choose a file
Please upload Hardship Documents and Unemployment or Laid Off letter.
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Are you a renter?
Yes
No
Do you have utility shut-off notice or are your utilities shut off?
Yes
No
Can you demonstrate/show why you couldn't pay your utilities?
Yes
No
Upload Utility Hardship Documents
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Choose a file
Please upload Utility shut off documentation and hardship document.
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Are you first time Sec-8 voucher recipient requiring a security deposit?
Yes
No
Are you a US citizen? (answering will not affect your eligibility)
Yes
No
Please describe your need.
Are you homeless? (fire victim; DV victim; natural disaster; shelter; hotel stay by agency; locked out)
Yes
No
Did you contact 211?
Yes
No
Please specify
Please Select
Domestic Violence Victim
Home Fire Victim
Suffer from a Natural Disaster
Hotel Stay
Shelter
Locked Out
Did you obtain a restraining order?
Yes
No
Upload Restraining Order Documents
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Choose a file
Please upload domestic violence report.
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Do you have a Red Cross referral or fire report?
Yes
No
Upload Red Cross or fire Documents
Browse Files
Drag and drop files here
Choose a file
Please upload Red Cross referral or fire report.
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Is your home uninhabitable?
Yes
No
Do you have a report from a government agency, stating you must relocate?
Yes
No
Do you have any of the following (shelter letter, hotel voucher, eviction notice, 211 referral)?
Yes
No
Upload 211 Documents
Browse Files
Drag and drop files here
Choose a file
Please upload report from agency or other homeless documentation.
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Save
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