United Christian Ministries: Financial Assistance Request Form

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Our service area includes Pickens County and the Powdersville area of northern Anderson County (with an Easley address).

Please note that we may not be able to assist you financially if....

* you do not have any proof of household income for the last 4 weeks or a pending medical or employment claim.

* you do not have proof of a recent emergency that affected your ability to pay your bills.

* you owe more than one month of rent or utility bills.

Email *

Today's Date *

YYYY

What is your FIRST and LAST name (as they appear on your picture ID)? *

Have you received financial assistance from United Christian Ministries before? *

Yes

I'm not sure or I don't remember

Required

What kind of financial assistance are you requesting help with today? *

Utility bill assistance (electric/water/sewer)

Utility deposit

Rent assistance

Rent deposit

Heating assistance (fuel)

SNAP application or recertification assistance

Required

What is the financial emergency that has caused you to not be able to pay your bill? *

What type of proof do you have of your financial emergency or the reason you are unable to pay your bill? *

pay check stubs showing a significant reduction in hours

Disability Denial Letter

Letter from new employer about start date, hours you will be working & how much you will get paid per hour

receipt(s) of recent, unexpected purchase(s)

discharge papers for a recent, unexpected health issue

other

Required

Do you owe more than one payment (rent or utilities)? *

yes

Required

Please provide a phone number where you can be reached during the day. *

How many people currently live in your household? *

What are the names of each person living in your household?

What city do you live in?

*For assistance in Anderson County, please contact AIM at 864-226-2273.

*For assistance in Greenville County, please contact United Ministries at 864-232-6463.

Easley

Pickens

Liberty

Six Mile

Norris

Sunset

Central

Clemson

Marietta

Why are you requesting financial assistance? *

Why are you unable to come to our office? *

You will receive an email from UCM Reception (ucmpc2018@gmail.com) about the required documents for you to email. Please check your trash/junk/spam if you don't see an email within two days.

Please note that your online request can take up to a week to process. If you are in danger of disconnect or eviction this week, we advise you to come to our office on Monday, Wednesday or Friday from 9:00-11:00am with the required documents (see below).

I understand that before I receive a call to go through the assistance process, I must email the following documents to ucmpc2018@gmail.com (all boxes must be checked to proceed.) *

Social Security cards for everyone in the home

Picture ID

Proof of earned and/or unearned income (pay check stubs, bank statement, child support court order, 2023 Award Letter, unemployment deposits, worker's comp, disability denial letter) for everyone in the home for the last 4 weeks.

Proof of recent emergency that has prevented you from paying your bill (receipt from car repairs, medical expenses, disability denial, etc.)

An eviction or late notice if seeking rental assistance

For utility assistance: a copy of your current utility bill if seeking utility assistance

For rent assistance: a copy of your lease or a letter from your landlord with your new address and their contact information if seeking utility deposit assistance. (If you're in need of a Duke Energy deposit, you must first call them and obtain an account number.)

For a rent deposit: a copy of your lease or a letter from your landlord with the following information: new address, deposit amount, monthly rent amount, and landlord's contact information.

Required

Once we receive ALL the required documents, a UCM representative will call you between 9am-4pm for an intake interview about your situation. Below are the topics that will be discussed. Please check each box so that you will be prepared to answer these questions. *

Household Profile (names of everyone in the home, their dates of birth, genders, relationships to you, education levels)

Monthly Income (employer name or type of income for everyone in the home, $ per hour and hours per week working, gross monthly income, SNAP benefit amount)

Monthly Expenses (rent or mortgage, phone, electricity, water, heat, transportation, medical, loans, credit cards, child care, tobacco, Internet, cable, etc.)

Required

We often need to contact other agencies in order to determine the approval or denial of your request for financial assistance. This may include your utility company, landlord, employer or other local agencies that may be able to assist you financially. *

I hearby authorize United Christian Ministries (UCM) to request and/or release any and all information concerning my employment, financial affairs, applications for assistance, family & personal relationships, and such other information as may be needed to determine the approval or denial of my request to UCM for assistance. Furthermore, I certify that the information given to a UCM representative to be true. I understand that if such information is found to be false, I forfeit the right to receive assistance from UCM both now and in the future.

Required

I understand that United Christian Ministries may not be able to assist me financially if....

* I do not have any proof of income for the last 4 weeks or proof of a pending medical claim.

* I do not have proof of a recent emergency that affected the ability to pay my bills.

* My past due notice includes two or more months.

Yes, I understand

Required

A copy of your responses will be emailed to the address you provided.

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