Ada County Non-Medical Assistance Application

USE THIS FORM ONLY FOR ASSISTANCE WITH:

• Rent
• Utilities
• Electric Bills
• Heating Bills
• Phone Bills
• Water Bills
• Indigent Deceased

Please Note: Files formatted in Portable Document Format (PDF) require the Adobe Acrobat Reader to access.
You can download the free reader directly from Adobe. Acrobat and the Acrobat logo are trademarks of Adobe Systems Incorporated.
 

General Assistance Application Form

Ada County Non-Medical Assistance Application

USE THIS FORM ONLY FOR ASSISTANCE WITH:

• Rent
• Utilities
• Electric Bills
• Heating Bills
• Phone Bills
• Water Bills
• Indigent Deceased

Please Note: Files formatted in Portable Document Format (PDF) require the Adobe Acrobat Reader to access.
You can download the free reader directly from Adobe. Acrobat and the Acrobat logo are trademarks of Adobe Systems Incorporated.
 

General Assistance Application Form