Form Swojfs 2 PDF Details

In our communities, the path to securing public assistance is often navigated through detailed documentation and collaboration between households and local government agencies. The Swojfs 2 form serves as a vital link in this chain for residents of Southwest Ohio, specifically within Clermont County. Administered by the Clermont County Department of Job and Family Services Office of Adult, Child, and Family Stability, this form facilitates a crucial step in verifying the living situation and utility needs of individuals and families seeking assistance. By meticulously collecting case information, consenting to the release of essential data, and detailing household member specifics alongside tenant, rent, and utility information, the form bridges the gap between private lives and public support. Its structured format, requiring signatures from both tenants and property owners or managers where applicable, underscores the importance of accuracy and honesty in the application process. Furthermore, the inclusion of contact information for the Clermont County Department of Job and Family Services not only streamlines the process of submission and inquiry but also highlights the accessible nature of support within the community. As such, the Swojfs 2 form stands as a testament to the collaborative effort required to navigate the complexities of public assistance eligibility and allocation.

QuestionAnswer
Form NameForm Swojfs 2
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namessubsidized, subsidy, Caseworkers, SWOJFS

Form Preview Example

Southwest Ohio

County Departments of Job & Family Services

County Agency: Clermont County Dept. of Job and Family Services Office of Adult, Child and Family Stability Address: 2400 Clermont Center Dr. Batavia, Ohio 45103 Phone: 513-732-7111 Fax: 513-732-7216

Website: www.acfs.clermontcountyohio.gov

HOUSEHOLD MEMBER / SHELTER / UTILITY VERIFICATION

PART I: Case Information: To be completed by the COUNTY DEPARTMENT OF JOB AND FAMILY SERVICES

Case Name:

Case Number:

Date Sent:

Tenant Name: (if different)

Caseworker’s Name / District:

Phone:

PART II: Release of Information: To be read and signed by the TENANT

M y s i g n a t u r e b e l o w m e a n s t h a t I g i v e t h e p e r s o n i n d i c a t e d b e l o w p e r m i s s i o n t o f u r n i s h

a l l i n f o r m a t i o n a b o u t m e t h a t i s r e q u e s t e d o n

t h i s f o r m . I u n d e r s t a n d t h i s i n f o r m a t i o n w i l l b e u s e d t o e s t a b l i s h m y e l i g i b i l i t y f o r p u b l i c

a s s i s t a n c e . I a l s o g i v e t h e D e p a r t m e n t o f J o b

a n d F a m i l y S e r v i c e s p e r m i s s i o n t o c o n t a c t t h i s p e r s o n t o o b t a i n o r c l a r i f y a n y i n f o r m a t i o n c o n t a i n e d o n t h i s f o r m .

 

Tenant Signature:

Phone:

 

Date:

 

 

 

 

 

PART III: Household Member Information: To be completed by:

PROPERTY OWNER/PROPERTY MANAGER; or

NON-RELATIVE/NON-HOUSEHOLD MEMBER

List all individuals who live at this address: (including children) Use the back of this form if additional space is required.

 

 

Relationship

 

Last 4 digits of

Date (s)he began or

First Name

Last Name

Date of Birth

Social Security

will begin living at

to Tenant

 

 

(optional)

Number (optional)

above address

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PART IV:

Tenant/Rent/Utility Info: To be completed by PROPERTY OWNER OR PROPERTY MANAGER ONLY to

 

 

 

 

 

 

 

First Name

 

 

 

 

 

 

 

 

Last Name

 

 

 

 

 

 

 

 

Tenant Name(s) who signed the

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

rental agreement: (First & Last)

First Name

 

 

 

 

 

 

 

 

Last Name

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Street Address:

 

 

 

 

 

Apt. # or Floor:

 

City:

 

 

 

 

 

State:

Zip:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Enter total amount of monthly rent charged to tenant. (DO

$

 

 

Type of Structure:

 

 

 

 

 

 

 

Check which of the following the tenant

 

NOT include arrearage, late fees, optional fees, lot rent or

 

 

 

 

Single Dwelling

Apartment Complex

 

 

must pay themselves:

 

 

 

subsidy.)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Duplex

 

 

Other

 

 

Heat

Sewer

Trash

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Is rent subsidized?

 

 

 

$

 

 

 

Mobile Home

 

 

 

 

 

 

 

Gas

Water

Phone

 

No;

Yes – If yes, total amount of monthly subsidy:

 

 

 

 

If mobile home,

 

 

 

 

 

Electric

Air Conditioning

 

 

 

 

 

 

 

 

 

 

 

tenant lot rent: $

 

 

 

 

 

Other

 

 

 

 

 

Does the tenant receive a utility reimbursement check?

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Unknown;

No;

Yes – If yes, enter amount:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

My signature below indicates that I completed this form and it is accurate to the best of my knowledge.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Signature of person completing form:

 

Address:

 

 

 

 

 

 

 

Phone:

 

Date:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Are you the property owner/property manager?

No;

Yes

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Are you someone other than the property owner/property manager?

No;

 

Yes

 

 

 

 

 

 

 

 

If yes, specify relationship:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SWOJFS 2 (1-11)

Form Swojfs 2 isn’t the one you’re looking for?

Related Documents