KHPP Application

Contact Information

Last name

First name

Telephone

Street Address

Apartment or Ste Number

* The assistance address must match the address submitted. An apartment number must be provided if assistance is for an apartment.

City

State

Zip Code

One entry per household per month. Multiple entrants may disqualify households from current and future lottery selection.
Recipients are selected by random lottery selection. Calls, emails, and office visits do not increase the chance of selection. Selectees and non-selectees are notified by the 15th of each month.

Assistance Amount Requested:

*Whole dollar amounts only; no dollar signs, commas, or decimals

* No partial payments will be provided. Balance will be verified prior to payments and must be less than $2,500.

Assistance Type

* The files below will be required IF SELECTED

Ten-Day Demand Notice or other form of payment demand (if applicable) or utility bill notification of discontinuation.
Proof of income, by the way of:
- Pay stubs
- Bank statements
- TANF statements
- Housing Voucher assistance statement
Adult Identification:
- DL
- Passport
- Birth Certificate
- Other I-9 Approved Identification Verification
Child Identification:
- Passport
- Birth Certificate
- Other I-9 Approved Identification Verification
Lease or Mortgage Statement (Lease must show the total costs/number of bedrooms/lease length/signature.)
Release of Information Form with authorization to contact the appropriate agency (phone and email). (Click Here to Download)