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Application for Public Assistance

Word Version

The Word version of the Application for Assistance is set up as a form, which can be completed electronically. Hitting the tab button on the keyboard will take you to the next enterable field. Once the application is completed, print the application and sign on the second page and the third from last page. Submit the completed and signed form to your local Office of Public Assistance

To save and print the Application for Assistance, if you have Word on your computer:

  • Right click on the link below and select "save target as". Choose the location (disk or hard drive) to which you would like to save the application file and select save. Then, minimize or close your browser and open the file to which you saved your appliction.

PDF Version

You may wish to apply for Public Assistance by downloading the application. You will need to print the application and submit the completed and signed form to your local Office of Public Assistance. Click below to download the application.

Listed are all of the counties and the addresses for the Office of Public Assistance for that county.

Application for Public Assistance PDF

Application for Public Assistance Word