Please note that all required documents may be uploaded by taking a picture with your phone. Please be sure that the document can be read clearly.
By signing this Application, I agree to allow Goshen HELP to share this application with The Salvation Army and/or Energy Share for the purpose of obtaining resources on my behalf.
Self-Declaration for Zero Income or missing required documentation
(Only complete if you have no source of income or are missing any of the required documentation.)
I do hereby declare under penatly of purjery that I have received no income from any source during the past 30 days and that I have been unemployed during that time.