PY 2023 EAP Flyer
PY 2023 Application Packet
PY 2023 Application Only
PY 2023 Large Print Application
PY 2023 Utility Affidavit
PY 2023 DWD Release Form
PY 2023 Direct Benefit Payment Form
PY 2023 Declaration of Absent Household
PY 2023 EAP Checklist
PY 2023 Change of Address Form
PY 2023 Referral Form

* If you have had ZERO income for the past three months, please fill out the PY 2023 Income Verification Affidavit

If you have utilities in rent, you must provide PY 2023 Landlord Affidavit signed by your landlord, stating that the utilities are in the Landlord’s name.


P.O. Box 11469
Indianapolis, IN 46201

Drop off:
Monday-Friday 9am-4pm
John Boner Neighborhood Center
2236 E. 10th St.
Indianapolis, In 46201

PY 2023 Appeal Rights