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Hendry County, FL

forms@hendryfla.net

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_________________
Signature HereClick to Sign
04/19/2024Click to Sign
Your Name HereClick to Sign
04/19/2024
Signature HereIan Proverbs, OMB Coordinator Will Sign Here
Signature HereJennifer Davis, County Administrator Will Sign Here
04/19/2024

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Upload Attachment(s)

All of the following documents must be attached to this application:

  • Most recent tax return
  • Copy of Valid Identification for every household member 18 years and older (Florida Driver’s License, Florida Identification Card) with a Hendry County address.
  • Paystubs showing employment status as of March 1, 2020 or statement from employer
  • Documentation of all income from the entire household as reported above (for example: unemployment compensation, Social Security, pension, alimony, etc.)
  • Self-Declaration Form for all adult household members who report no income or are self-employed
  • Bank Statements (checking, savings, money market, annuities, or other investment accounts) for the Applicant, Co-Applicant, and all other adults in the household

The following documents must be attached to this application (as applicable for the assistance being sought):

  • Mortgage Statement (showing the breakdown of the payment and arrearage / amount due)
  • Current Lease (showing monthly rent)
  • Statement from a landlord (showing the arrearage / amount due)
  • W-9 for landlord or mortgage company
  • If the landlord does not have a Business Tax Identification Number a Social Security Waiver must be completed
  • Documentation for a Utility Deposit (showing the amount needed)

​All required information must be submitted in order for application to be approved.


There is a 250MB limit on each attachment.

Copy of most recent tax return [REQUIRED] Click Here to Upload
Copy of Valid Identification for every household member 18 years and older (Florida Driver’s License, Florida Identification Card) with a Hendry County address. [REQUIRED] Click Here to Upload
Paystubs showing employment status as of March 1, 2020 or statement from employer. [REQUIRED] Click Here to Upload
Documentation of all income from the entire household as reported above (for example:unemployment compensation, Social Security, pension, alimony, etc.). [REQUIRED] Click Here to Upload
Self-Declaration Form for all adult household members who report no income or are self-employed Click Here to Upload
Bank Statements (checking, savings, money market, annuities, or other investment accounts)for the Applicant, Co-Applicant, and all other adults in the household. [REQUIRED] Click Here to Upload
Mortgage Statement (showing the breakdown of the payment and arrearage / amount due) or Current Lease (showing monthly rent) [REQUIRED] Click Here to Upload
Statement from a landlord (showing the arrearage / amount due) Click Here to Upload
W-9 for landlord or mortgage company Click Here to Upload
If the landlord does not have a Business Tax Identification Number they must complete a Social Security Waiver must be completed Click Here to Upload
Documentation for a Utility Deposit (showing the amount needed) Click Here to Upload
If you are unable to submit documents ("Continue" button below), please scroll up to verify that all required documents have been uploaded. Click Here to Upload