Preparing for Your Utility Assistance or Food Pantry Appointment

Younger couple sitting with lap top looking at screen with a piece of paper.

Before your appointment with the Human Services staff, please gather the following documents. All documents must be provided before we are able to provide you with services.

Appointments will be rescheduled if you are unable to produce the needed documentation.

  1. Proof of residency (dated within the last 30 days)
    • Provide one of the following:
      • Current lease
        • Must be in the applicant's name seeking assistance.
        • Must be dated within the last 12 months
      • Official correspondence
        • Must be in the applicant's name seeking assistance
        • Must contain a street address on the bill. PO Boxes are not acceptable forms of residency.
        • Examples include: documents from government agencies (IRS, Social Security, DCF), Driver's license renewal, voter registration card
      • Current utility bill
        • Must be in the applicant's name seeking assistance.
        • Must contain a street address on the bill. PO Boxes are not acceptable forms of residency.
  2. Picture ID for all adults (18 yrs & older) in the household.
    • Provide one of the following for each adult household member:
      • Driver's license
      • U.S. or Foreign Passport 
      • Foreign photo ID
      • Military ID
      • State ID
      • Corrections ID
      • Permanent Resident card or Alien Registration Receipt Card (Form I-551)
      • Employment Authorization document that contains a photo (Form I-766)
      • School ID
      • Government ID
      • Note: Employer ID's are not accepted as identification, unless they are issued by a government agency. 
  3. Social Security cards for all members of the household.
    • Provide Social Security cards for all adults and children in the household.
  4. Proof of guardianship/residency - minor children, age 17 and younger (if applicable)
    • Provide one of the following:
      • Birth certificate
      • Social Security card
      • Tax return
      • School enrollment (visual verification on the school app is acceptable)
      • Immunization record
      • Insurance card
      • Passport
      • Parenting Plan
      • Guardianship papers
  5. Proof of guardianship/residency - dependent adults (if applicable)
    • Please provide one of the following:
      • Power of Attorney
      • Petition for Appointment of Guardian (official court document)
      • Legal guardianship
      • Letters of Guardianship (official court document)
  6. Proof of income for the last 30 days for all adults in the household 18 years and older. Note: 18-year-olds attending high school do not have to show proof of income.
    • Provide all that apply:
      • Paycheck stub – Payments/ pay stubs received in the last 30 days.   
      • Social Security Administration (SSA) benefit letter for the current year.
      • Unemployment letter – online pay card report
      • DCF cash benefit letter or print out from ebtedge.com
      • Bank statement – Bank statement must be within the last 30 days, and can be used for self-employed or pension. All deposits are considered income. Must include the applicant's name on the bank statement.
      • Payment app statement - Statements from apps such as CashApp, Venmo, PayPal or Zelle. Must be submitted as a PDF and within the last 30 days for self-employment or contract work.
      • Proof of child support from the KANPAY system or a bank statement showing deposits of child support.
      • Cash Payment - If the employee is paid cash, copies of the checks or a letter from the employer stating their income for the last 30 days. The number of hours worked and the hourly rate should be included in the letter.
      • Self-Employment | Independent Contractor – Applicants can use personal bank or payment app statements to verify income.  

Required Forms

Before your appointment, please review, print and sign the following documents:

If you do not have access to a computer or printer, you can sign all paperwork on-site during your scheduled appointment.

If you have access to a computer but do not have access to a printer, you can complete paperwork through Adobe Sign prior to your scheduled appointment.

If you have access to a printer, you can print, sign, and email the documents to the Human Services staff prior to your scheduled appointment.

Contact Information

Johnson County Human Services
913-715-6653