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 14, 2010, at 4:00 p.m. Any applications and
backup documentation received after the deadline will not be processed.

This is a STRICT DEADLINE!!

A new application and backup documentation is required each year that you apply for
assistance. Complete your application IMMEDIATELY and submit all required backup
documentation with your application.
Send only copies of your backup documentation with your application -- DO NOT SEND
ORIGINALS -- they will not be returned and copies will not be made for you at our office.

****No applications or backup documentation will be accepted after
4:00 p.m. on Thursday, October 14, 2010.****

All of the following BACKUP DOCUMENATION must be submitted with your application:
Proof of residency for ALL members in your household (valid driver’s license or
Michigan I.D.), and current utility bill with your name and address listed

Proof of mortgage (buyers) or lease agreement (renters) with your name and address
listed
Proof of ALL dependents (birth certificates)
If you are not the birth parent, submit guardianship papers.
Proof of ALL income (2009 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 documentation to:
Southfield Human Services Department
c/o Southfield Goodfellows
26080 Berg Road
Southfield, MI 48033

(248) 796-4540 (Call if you have any changes after you submit your application)
(248) 796-4545 (Fax)

Websites – www.cityofsouthfield.com and www.southfieldgoodfellows.org
Southfield Goodfellows
Application
Application is no longer available online for 2010