Where to Submit Documents

In-person or Outside Drop Box: 12 W. Burnham Ave.

Fax: 918-224-6436 or

email: info@CCFOK.org

WHAT DOCUMENTS DO I NEED TO PROVIDE IF REQUESTING FINANCIAL ASSISTANCE?

If you are requesting financial assistance, you will need to provide several types of documentation. See below for a list of what you’ll need to submit depending on the type of assistance you are requesting. All documents must be readable.

 

PHOTO ID

• Picture/copy of government issued photo ID.

                Examples: Driver’s License, State issued ID, Passport, CDIB card, Veteran’s ID, etc.

• Name on the ID must match the name on the utility bill and/or lease agreement, or be the same as an occupant on the lease.

                If the name on the online application is different than the name on the bills, submit a copy of both IDs.

• You must be at least 18 years old to apply for assistance.

 

IF REQUESTING UTILITY BILL ASSISTANCE...

Pictures/copies of the entire utility bill for which you need help paying (electricity, gas and/or water). The whole bill must be in the picture.

• Bills should include name, address, utility account number, amount due and service dates.

• The name on the bills should match the name of one or more on the photo ID(s) you are submitting.

• The address on the bills must match the address on your online application.

 

IF REQUESTING RENT PAYMENT ASSISTANCE...

Tenant

Picture/copy of the first and last pages (signature page) of the lease agreement and the current rent due notice.

• The name of the occupant on the lease should match the name on one or more of the photo ID(s) you are submitting.

• The address on the lease must match the address on your online application.

• The lease agreement and rent due notice must include landlord’s name, address and contact information.

Property Owner / Landlord

Form W-9

Affidavit of Ownership

 

IF REQUESTING NON-NARCOTIC PRESCRIPTION MEDICATION ASSISTANCE...

Picture/copy of non-narcotic prescription information or container label.

• Information must clearly identify the patient and pharmacy contact information.

• The prescription must be current and eligible for refill.