Preparing for Your Appointment

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

Before your appointment with the Multi-Services Center, 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 documentation that includes client's name and street address (dated within the last 30 days). Provide one of the following:

  • Current lease that is in the resident's name seeking assistance.
  • Another official correspondence in resident's name seeking assistance - such as government correspondence (example: IRS, DCF or Social Security)
  • Current utility bill in resident's name seeking assistance.

2) Picture ID for adults (18 years and older) in household: Provide one of the following:

  • Driver license or expired driver license if the picture is recognizable. 
  • Passport – current /expired 
  • Military ID with social security number on it
  • State ID
  • Corrections ID
  • If a member of the household is 18 years of age and NOT in high school, then official picture ID is required  

3) Documentation for each child in the household. Provide one the following for each child:

  • School registration
  • Vaccination records
  • Tax returns
  • KanCare or Medicare card
  • Passport
  • Birth certificate

4) Proof of income for last 30 days for all adults in household 18 years and older (exception students in high school). 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
  • Bank statement – Bank statement must be within last 30 days, and can be used for self-employed or pension. All deposits are considered income. Must include client’s name on the bank statement.
  • Proof of child support from KANPAY system or bank statement showing deposits of child support.
  • Cash Payment – If employee is paid cash: copies of the checks or letter from employer stating their income for the last 30 days. The number of hours worked and hourly rate for last 30 days should be included on the letter.
  • Self-Employment – clients can use personal bank statements to verify income.

5)  If receiving prescription assistance, must provide prescription or medical order.

  • Social security cards are required for all members of the household (including children under 18).

Required Forms

During COVID-19, Outreach Services staff are practicing social distancing by collecting paperwork prior to appointments. Utility Assistance appointments are encouraged to be completed over the telephone during a scheduled appointment. Food Pantry appointments are completed in person with minimal physical contact with staff. 

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

Please email completed forms if you don't have access to a printer.

If you do not have access to a printer, our staff may receive verbal consent over the telephone in lieu of a signed form. 

Contact Information

Johnson County Multi-Service Centers