LHOI's Rent & Utility Assistance Application
Please complete the full application, including submitting the required documents. We are unable to accept applications without these. For any questions, please visit https://www.lincolnheightsoutreach.org/rent-utilities or call us at (513) 744-6260.
Eligibility
To be eligible for the Rent & Utility Assistance Program, please note the following; (1) Applicants must not have received financial assistance from this program within the last 12 months (ex: if you received $300 for utility assistance in November 2025, you would not be eligible to receive assistance again until November 2026 - for utilities or rent); (2) If applying for utility assistance, applicants must not currently be enrolled in the Percentage of Income Payment Plan (PIPP); (3) Eligible participants may receive up to $500 in assistance for utilities OR up to $500 in assistance for rent/mortgage (not both)
Contact Information
Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Secondary Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Have you or your household received funding from LHOI's Rent & Utility Assistance Program before?
*
Yes
No
When did you last receive funding from LHOI's Rent & Utility Assistance Program? Please note we are unable to accept your application if you have received financial assistance through this program in the last 12 months.
*
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Next
Are you experiencing homelessness?
*
Yes
No
Current Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Neighborhood
*
How many adults are in the household?
*
Please Select
1
2
3+
Do you have children you are responsible for?
*
Yes
No
Please list ages of all children in household (ex: 2mos, 5yrs, 16yrs)
*
What type of financial assistance are you applying for?
*
Rent or Mortgage (Current Month)
Rent or Mortgage (Past Month(s))
Housing Deposit
Utilities (Gas & Electric)
Utilities (Water)
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Next
Have you received a notice to leave the premises (3, 10 day notice)?
*
Yes
No
Have you received a court summons?
*
Yes
No
When is the court hearing?
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Do you live in subsidized housing?
*
Yes
No
Housing Provider/Landlord Name
*
Housing Provider/Landlord Name Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
What is the monthly rent/mortgage amount YOU are responsible to pay?
*
How many months are you behind on rent/mortgage?
*
What is the total amount due/owed to landlord?
*
Amount you will be able to pay, or raise from other sources?
*
What is the reason you are unable to pay your bill at this current time?
*
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Next
Do you have a disconnection notice?
*
Yes
No
Date of disconnection
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Is your utility currently shut off?
*
Yes
No
What is the total utility amount owed?
*
What is the minimum you must pay to avoid disconnection/get reconnection for utility?
*
Amount you will be able to pay, or raise from other sources?
*
What is the reason you are unable to pay your bill at this current time?
*
Back
Next
Is the deposit for a new rental lease or a to purchase a house?
*
Rental lease
Buying house
When is the deposit due?
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
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Next
Uploading Documents
Applicants can also fax their documents to our office: (513) 769-8501. If faxing, please include a cover page with your name. If you have to take a picture of your documents to then upload them, please make sure the whole document is visible, and the lighting is bright. If you are having issues with one of these methods, please call us at (513) 744-6260.
Are you faxing your documents? Fax Number: (513) 769-8501
*
Yes
No
Please attach a copy of your bill statement(s), rental contract, and eviction notice(s) if applicable.
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Please attach a copy of your utility bill(s), and disconnect notice.
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Please attach a copy of your rental contract.
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Submit
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