

| ATTENTION: SOUTHFIELD & LATHRUP VILLAGE RESIDENTS ONLY PLEASE READ THOROUGHLY THE INFORMATION REGARDING COMPLETING THE APPLICATION FORM. The DEADLINE for submission of applications for Southfield Goodfellows December Holiday Assistance is Thursday, October 15, 2009, at 4:00 p.m. Any applications and backup paperwork received after the deadline will not be processed. This is a STRICT DEADLINE!! A new application and background information is required each year that you apply for assistance. Complete your application IMMEDIATELY and submit all required backup paperwork with your application. Send only copies of your backup paperwork with your application -- DO NOT SEND ORIGINALS -- they will not be returned and copies will not be made for you at our office. Applications without backup paperwork will be denied. Application must be filled out completely by applicant. Application must be signed. ****No applications or backup paperwork will be accepted after 4:00 p.m. on Thursday, October 15, 2009.**** All of the following BACKUP PAPERWORK must be submitted with your application: Proof of residency for ALL members in your household (include a copy of valid driver’s license or Michigan I.D., and current utility bill with your name and address listed. Proof of mortgage (buyer’s) and proof of rental agreement (renter's). Proof of ALL dependents (copy of birth certificates). If you are not the birth parent, submit copies of guardianship papers. Proof of ALL income (copy of 2008 1040 tax return, or social security letter, or FIA letter, or reduced lunch award letter, or paycheck stub showing year to date information). Please return completed application and backup paperwork to: Southfield Human Services Department c/o Southfield Goodfellows 26000 Evergreen Southfield, MI 48076 (248) 796-4540 (Call if you have any changes after you submit your application) (248) 796-4545 (Fax) |