Required Documents for Economic Assistance Programs

A household is defined as anyone living under your roof.

  • Photo ID (Driver’s license or State ID)
  • Social Security Cards for all household members
  • Proof of disability if disabled
  • Proof of U.S. citizenship for all household members(U.S. birth certificate/ hospital birth record, U.S. passport, U.S. voter registration card, OWF award letter, U.S. military record, or other government documents that specify U.S. citizenship)
  • Most recent utility bills (gas and electric) Non-Regulated utility customers will need to provide corresponding bills showing the electric portion amount and co-payment for non-electric balance.
  • Landlord’s name, address & phone number (a lease is required for all new services)
  • Proof of income:


30 day verification from ALL sources for ALL household members that are 18 years of age and older including, but not limited to: weekly/bi-weekly paystubs, social security/SSDI, VA or disability benefits, pensions, unemployment, TANF, utility allowance

12 month verification is needed for:  self-employment and seasonal employment (teachers, construction workers, landscapers and etc.).

Most recent filed IRS 1040 is also required.

If the household income is below 30% of the federal poverty guidelines, you must may be required to provide further documentation to process your application. 

Such documentation may include:  letters of support (signed and dated with address and phone number of those individuals with specific details/amounts of assistance), child support received, gifts, foster care, adoption assistance, VA disability, senior employment, Ohio waiver  program, income earned by dependent minors, tax refunds/rebates, military allowances, PRC, FEMA, proceeds from reverse mortgage, IRS Tax Transcripts.

    • All Household members claiming zero income must be present and complete a self-declaration form.
    • All zero income HOUSEHOLDS must provide an IRS tax transcript or verification of non-filing.

This can be done by:

    • Phone: 1-800- 908-9946 (this method requires the customer to provide their Social Security Number, date of birth, street address, and zip code. Please allow 5 to 10 calendar days)
    • In Writing
      • Internal Revenue Service (IRS)
      • Return and Income Verification Services (RAIVS) Team
      • (RAIVS) Team
      • PO Box 145500
      • Stop 2800 F
      • Cincinnati, Ohio 45250
      • Fax #1-859-669-3592
    • Online
    • Visiting a local IRS Office
      • Akron Office- 2 S. Main St., Akron, OH 44308
      • Canton Office- 301 McKinley Ave. SW., Canton, OH 44702
      • Mansfield Office- 180 N. Diamond St., Mansfield, OH 44902

The forms below can be accessed and may be required to process your application.


  • Self-Declaration Form

  • Seasonal Employment Verification Form

  • Employment Verification Form

  • Self-Employment Income and Expense Form

  • Medical Eligibility Form


Print this list for your records.