Prc Franklin Application Details

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QuestionAnswer
Form NamePrc Franklin Application
Form Length4 pages
Fillable?Yes
Fillable fields97
Avg. time to fill out20 min 28 sec
Other namesprc application ohio, prc form, franklin county prc application, apply for prc online

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Franklin County

Department of Job & Family Services

1721 Northland Park Avenue

Columbus, Ohio 43229

P (614) 233-2000 F (614) 233-2398

PRC Application

The Prevention, Retention and Contingency program (PRC) is designed to provide short- term assistance for families struggling with a specific crisis situation or emergent needs. One Time or Short-Term assistance is limited to $1,500 per application, and issued only when assistance (alone or combined with other funding sources) can resolve the crisis. Multiple categories of assistance may be requested and approved in a single application.

PRC Approval is limited to one application per twelve-month period. PRC benefits do not reimburse already paid expenses. If otherwise eligible, applicants can receive Disaster-Related PRC benefits even if they have received One Time or Short-Term assistance in the previous twelve months.

Name _____________________________ Phone ______________ CRISE Case # ___________ OB Case # __________

Address ___________________________________________________ City __________________ State _____ Zip _______

Yes

No

Are you currently facing utility shut off or eviction notice?

Yes

No

Are you currently living with family or friends and trying to establish your own household?

Yes

No

Do you need assistance due to a government-declared disaster, flood, fire, or other personal disaster (see p. 4)?

One Time or Short-Term Assistance Categories

Check the box next to the requested area of assistance, and state the amount of assistance needed. Complete and return the application along with the necessary documentation described on page 2.

 

 

Amount

 

 

Amount

 

 

 

 

Amount

 

Gas

 

 

 

Security Deposit

 

 

Property Taxes

 

 

 

 

Water

 

 

Temporary Housing

 

Bus Passes

 

 

 

 

Electric

 

 

Bulk Fuel for Heat

 

Heating Fuel Deposit

 

 

 

 

 

 

 

Rent/Mortgage

 

 

Home Repairs

 

Auto Repairs/Maint.

 

 

 

 

 

 

 

 

 

 

 

Driver’s License Reinstatement

 

 

 

 

 

 

 

Household Composition

Complete the chart below for everyone living in your home, including yourself. You must verify all household income received in the last 30 days for all members of your household. In addition, for a shelter request, you must verify all household income for the next 30 days for all members of the household.

Are you currently pregnant?

Yes

No

Name

Age

Relationship to

Applicant

SELF

SS Number

Income Source

Monthly Amount

By signing this document, I acknowledge that I have read and understand the scope of assistance provided by PRC as well as the requirements necessary for consideration. Furthermore, I understand that submission of this application is NOT a guarantee of approval. By signing, I grant permission for FCDJFS to gather and report information as needed in the process.

 

Signature

 

Date

FCDJFS #3800a PRC Application Rev 8.2018

Page 1 of 4

 

Franklin County

PRC Application continued

Department of Job & Family Services

1721 Northland Park Avenue

 

 

 

 

Columbus, Ohio 43229

P (614) 233-2000 F (614) 233-2398

Crisis Descriptions & Requirements

Utility Bills

General Requirements:

During the winter heating season, PRC cannot be used to pay for an applicant’s heating utility unless the applicant has been denied for the Home Energy Assistance Program (HEAP). PRC can be used to pay for an applicant’s non-heating utilities.

Payment may be made to prevent shut-off or restore service.

Required Documentation:

Proof of amount due.

Utility bill showing most recent balance and past due amounts.

Rent/Mortgage

General Requirements:

Payment cannot be made for the following: o Closing costs or down payments;

o Second mortgages;

o Home equity lines of credit; o Late fees;

o Legal expenses; o Penalties;

o Court costs; or

o Eviction filing fees without proof of an eviction filing.

Payment cannot be made if the applicant lives with or is employed by the landlord.

Payments must be at least 5 days overdue or eviction proceedings must have been filed. Required Documentation:

Current signed lease agreement or mortgage documentation.

Signed and itemized statement of amount due and the month(s) for which payment is requested.

A copy of any subsidized housing agreement, if you receive this assistance.

Security Deposit

General Requirements:

Payment cannot be made for pet deposits.

Payment cannot be made if the applicant lives with or is employed by the landlord. Required Documentation:

Copy of the PRC Shelter Deposit Repayment Agreement (FCDJFS 3805) signed by the applicant and landlord.

Copy of the current lease agreement.

If applicable, a copy of any subsidized housing agreement.

Home Repairs

General Requirements:

Applicant must be the homeowner.

Repairs must be essential and affect the home’s basic structure (e.g., roof, plumbing, walls, etc.). Required Documentation:

Proof of home ownership.

Written repair estimate.

FCDJFS #3800a PRC Application Rev 8.2018

Page 2 of 4

 

Franklin County

PRC Application continued

Department of Job & Family Services

1721 Northland Park Avenue

 

 

 

 

Columbus, Ohio 43229

P (614) 233-2000 F (614) 233-2398

Crisis Descriptions & Requirements

Emergency Shelter or Temporary Housing

General Requirements:

Applicants must need emergency shelter or temporary housing because: o They are homeless and not living in the home of someone else;

o They are residing in a domestic violence shelter;

o Their residence is uninhabitable due to a natural, chemical, or other declared condition within the last 3 months; or

o Their residence is unsafe due to criminal activity within the last 3 months.

Payment will be made for no more than 2 months of expenses.

Required Documentation:

Proof of inhabitability or unsafety.

Verification of circumstance occurring within the last three months.

Driver’s License Reinstatement

General Requirements:

The applicant’s driver’s license must have been suspended for one of the circumstances identified in the PRC Plan.

The applicant is otherwise eligible for reinstatement but lacks the funds to pay the reinstatement fee(s). Required Documentation:

Proof of employment or job offer.

Proof of type of suspension.

Auto Repairs and Maintenance

General Requirements:

Repairs generally must be completed within Franklin County.

Repair costs cannot be more than the retail value of the vehicle. Required Documentation:

The applicant’s valid driver’s license.

Proof of employment or a job offer for at least 20 hours per week at or above minimum wage.

Proof of ownership or lease of the vehicle and proof of liability insurance; and

Two estimates for the repairs from businesses registered with the Ohio Secretary of State’s office.

Property Taxes

General Requirements:

Can be paid for either the first- or second-half year taxes, but not both.

Bulk Fuel for Heat

General Requirements:

May include the purchase of fuels such as propane, heating oil, coal, or wood.

Applicant must have less than a 20-day supply of bulk fuel remaining.

FCDJFS #3800a PRC Application Rev 8.2018

Page 3 of 4

 

Franklin County

PRC Application continued

Department of Job & Family Services

1721 Northland Park Avenue

 

 

 

 

Columbus, Ohio 43229

P (614) 233-2000 F (614) 233-2398

Crisis Descriptions & Requirements

Bus Passes

General Requirements:

Cannot exceed four months’ worth of passes.

Must be needed to support the applicant’s participation in one or more of the following: o Workforce, training, or education program;

o Job search;

o Job interviews; or

oEmployment.

Required Documentation:

Proof of participation in a workforce, training, or education program; job search; job interview(s); or employment.

Heating Fuel Deposit

General Requirements:

Deposits must be limited to the amount needed for service connection.

Charges from a prior residence cannot be paid.

Required Documentation:

Proof of amount needed for deposit.

Disaster-Related PRC

General Requirements:

Family Disaster-Related PRC Assistance is available to families residing in areas affected by a publicly- declared disaster or under a state of emergency declared by the Governor of Ohio or families experiencing a personal disaster verified by a nonprofit disaster-relief agency.

Applications must be made within 30 days from the date of the disaster.

Applicants may request multiple items (up to $750.00 collectively).

Eligible household expenses may include:

oHousehold items (dishes, sheets, pots and pans, towels, eating and cooking utensils);

oNew or reconditioned furnishings (bed frames, mattresses, box springs, dining room table set);

oRepair or purchase of appliances (new or reconditioned) – limited to cooking and refrigeration, only;

oGeneral clothing (new or second-hand) – case manager must explore community resources first; and

oBaby items (limited to crib, car seat, baby clothing, and supplies such as diapers and formula).

Eligible household-related expenses may include:

oLabor and/or supplies for essential home repairs;

oRepair or purchase of furnace or water tank; and

oHome repairs affecting basic structure (e.g., roof, plumbing, walls, etc.) (for homeowners only). Documentation Required:

For a personal disaster, proof of a personal disaster from a nonprofit disaster-relief agency.

FCDJFS #3800a PRC Application Rev 8.2018

Page 4 of 4

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