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Testing Rent/Utility ApplicationGreg Nelson2026-01-02T16:44:22-06:00

Rent / Utilities Assistance with Salesforce

Step 1 of 7 - HEAD OF HOUSEHOLD INFORMATION

14%
This field is for validation purposes and should be left unchanged.
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This field is hidden when viewing the form

DIRECTIONS: Read question carefully. If you fail to fill out any part of this application truthfully, the application will be closed without review. If you do not live in our Primary Service Area and you select one of our service area zip codes, our system tells us your address is not in our area. We will consider this as providing false information and closing the case without review. If you do not live in our Primary Service area you should call 211 for an organization that services, your area. YOU SHOULD REVIEW EACH SECTION AFTER YOU HAVE FILLED IN FIELDS BEFORE GOING TO NEXT SECTION. DO NOT LEAVE OUT/OFF ANY INFORMATION THIS WILL CAUSE AN INACCURATE RESPONSE FROM US OR YOUR CASE TO BE CLOSED. ONCE YOU COMPLETE EACH SECTION AND CONTINUE YOU MAY NOT BE ABLE TO GO BACK TO CORRECT OR ADD/DELETE INFORMATION.

DO NOT APPLY MULTIPLE TIMES - YOUR FILE WILL BE CLOSED WITHOUT A RESPONSE. *****
By checking this box, A) I agree to receive texts from Now-Forward at the mobile number listed on your application. B) I have read the guidelines and basic requirements on the previous page, and I agree that completing the application does not guarantee assistance. C) I also agree that all information I provide is accurate and truthful and understand that if any information is not provided or is inaccurate my request for assistance will be closed without consideration.(Required)

HEAD OF HOUSEHOLD INFORMATION

Name (You must type in your full First, Middle and Last name)(Required)
Address

HEAD OF HOUSEHOLD INFORMATION (CONTINUED)

Only Driver's License, Passport, or ID Number
MM slash DD slash YYYY

HOUSEHOLD INFORMATION

MM slash DD slash YYYY
DO NOT LIST YOURSELF BELOW - ONLY ADDITIONAL INDIVIDUALS LIVING AT RESIDENCE WITH YOU

OTHER PEOPLE LIVING IN HOUSEHOLD

List Information for everyone living in your household – both adults and children. Failure to list the all household members (including first and last name) will cause your application to be declined.

YOU MUST INCLUDE ANYONE NOT ON LEASE
Name Age Relationship to You Actions
     
There are no Household Members.

Maximum number of household members reached.

HOUSEHOLD INCOME INFORMATION

You will be required to provide proof of your income and all working individuals in the residence.

You must have CURRENT income to receive NOW-FORWARD'S financial assistance

You must have current verifiable income. If you do not work at the employer on the day that you apply, then that employer does not count. We do accept SSI, SSDI and Unemployment as income. You must be working 35-40 hours a week. You are required to complete this information for any working roommate, spouse, boyfriend/girlfriend, or any other individual living at the address listed on the application.
Recipient Source of Income Monthly Net Income From This Source Employer’s Name Actions
       
There are no Sources of Income.

Maximum number of sources of income reached.

FINANCIAL ASSISTANCE NEEDED

Only one page. The page must include the address, move-in date, and household occupants.
Accepted file types: jpg, png, pdf, doc, Max. file size: 20 MB.
Maximum two pages.
Accepted file types: jpg, png, pdf, doc, Max. file size: 50 MB.

WHAT HAPPENS NEXT

A RESPONSE WILL BE EMAILED TO YOU WITHIN 2-4 DAYS ONCE YOU SUBMIT.
IF YOU FAIL TO READ SCREEN AFTER YOU CLICK SUBMIT FOR IMPORTANT DIRECTIONS YOUR APPLICATION CAN BE CLOSED WITHOUT RESPONSE.

YOU ONLY NEED TO CLICK ONCE TO SUBMIT APPLICATION. YOU WILL RECEIVE AN EMAIL AND A POP-UP MESSAGE WHEN THE APPLICATION TRANSMITS.

You must have income to receive NOW-FORWARD'S financial assistance

Now-Forward

2875 Merrell Road
Dallas, TX 75229
info@now-forward.now-forward.org

214.358.8700
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