ALL INCOME MUST BE PROVIDED AND MAY BE VERIFIED. IF INCOME IS LATER FOUND THAT IS NOT DISCLOSED WITH THIS APPLICATION, BENEFITS MAY BE SUSPENDED OR DENIED. HANDWRITTEN INCOME WILL NOT BE ACCEPTED! BANK STATEMENTS THAT SHOW WHO AND WHERE DEPOSITS ARE FROM WILL BE ACCEPTED AS LONG AS NAME AND ADDRESS MATCH.
If documentation is not provided with original application, this application is denied and you must reapply.
Please read: I confirm that the information provided is complete and correct to the best of my knowledge. I am also aware that any attempt to obtain aid fraudulently from Waxahachie CARE Services will result in my application being denied and services suspended. I understand that any and all information supplied by me on this form may be verified. I give my permission to Waxahachie CARE Services to share information with other agencies and utilities, if necessary. We do not pay/pledge first and last month on utility, rent, fees or deposits.
This application does not guarantee any form of payment, pledge or responsibility from Waxahachie CARE Services. Incomplete applications will not be considered. If documentation is not provided with original application, this application is denied.