Renewal Documents Checklist

Forms Required

______ Client Information Sheet (one for each adult)

______ United Cooperative Service Sheet

______ Release of Information Sheet

Copies Required

______ Driver’s License or Government Issued Identification*

______ Utility Bill (Electric, Water, Gas)**

______ Lease/Mortgage**

______ Income last 30 days (Check stub, Social Security, etc)***

______ Income before COVID (Before March 15th) – 2 statements

______ Employee letter, unemployment letter, or a document stating when you were                            released from job (if applies)

______ Social Security cards (Every member of the house)****
               or birth certificates  or  Medicaid letter

______ Employee letter, unemployment letter showing your release date or reduced hours

               (if applies)

 

*Personal ID (All adults in household)

• Driver’s License or

• Any government issued ID,  unless approved by Harvest House Management

**Proof of Residence (All adults in household)

• Utility Bill ( water, gas, electric )

• Lease/Rental Agreement

• If you currently live with someone and do not receive a bill in your name a piece of mail addressed to you will be accepted.

***Proof of Income (All adults in household)

• Pay statement

• Government award letter ( SSI, SSD, Medicaid, Child Support)

• Letter from employer signed and dated with salary amount if paid in cash.

****One of the following for each adult and child in your household that you have

      legal guardianship:

• Social Security card  (All adults and children)

• Birth certificate

• Medicaid award letter with adult/child’s name  ( PHOTO COPIES ARE ACCEPTED)

 

Harvest House requires its clients to present these documents every six months to recertify.

Revised 07/07/2020

 

Any questions call 817-295-6252 or email Connie at connie@yourharvesthouse.org or Sue at