COVID-19 Support 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 fieldsAre you a Henry County Resident? *YesNoDo you have mortgage, rent, or utility bills which are delinquent due to COVID-19? *YesNoUpload Bill *Required fieldsFirst Name *Last Name *Phone *Email *Physical Mailing Address *Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeAfghanistanAlbaniaAlgeriaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCentral African RepublicChadChileChinaColombiaComorosCongo (Brazzaville)CongoCosta RicaCote d\'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast Timor (Timor Timur)EcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFijiFinlandFranceGabonGambia, TheGeorgiaGermanyGhanaGreeceGrenadaGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiKorea, NorthKorea, SouthKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorwayOmanPakistanPalestinian TerritoryPalauPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint VincentSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited States of AmericaUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamWestern SaharaWestern SamoaYemenZambiaZimbabweCountryProof 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)Required fieldsIs your mortgage or rent delinquent due to lack of work due to COVID-19? *YesNoAre your utilities delinquent due to lack of work due to COVID-19? *YesNoPlease 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? *YesNoIf yes, please state the name of the organization. Type NONE if no. * *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. VerificationPlease enter any two digitsExample: 12This box is for spam protection - please leave it blank: