COVID-19 Support

Are you a Henry County Resident? *

YesNo

Do you have mortgage, rent, or utility bills which are delinquent due to COVID-19? *

YesNo

Upload Bill *

First Name *

Last Name *

Phone *

Email *

Physical Mailing Address *

Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeCountry

Proof of Henry County Residency *Acceptable forms of proof of residency: copy of utility bill, mortgage statement, rental lease (option to upload a picture or document)

Is your mortgage or rent delinquent due to lack of work due to COVID-19? *

YesNo

Are your utilities delinquent due to lack of work due to COVID-19? *

YesNo

Please explain the need for support: *

(include your plan not to need support in the next 30 days)

How many adults live in your household? *

How many children live in your household? *

Please upload your identification: *

Have you received support from a Henry County Nonprofit or Small business due to COVID-19 in the past 8 - 12 months? *

YesNo

If yes, please state the name of the organization. Type NONE if no. *

Eligibility Requirements

*No payment will be made directly to applicants. If awarded support, payment will be made directly to the mortgage company, rental property management company, or utility company.

Verification

Eligibility Requirements

All applicants must be Henry County residents. In order to be considered for support, there must be proof of financial need directly related to the COVID 19 pandemic.

Required fields

Required fields

Required fields

*No payment will be made directly to applicants. If awarded support, payment will be made directly to the mortgage company, rental property management company, or utility company.

Verification