PY 2022 EAP Flyer

PY 2022 Application
PY2022 EAP-Request-for-Services
PY 2022 Utility Affidavit
PY 2022 DWD Release Form
PY 2022 Direct Benefit Payment Form
PY 2022 Declaration of Absent Household
PY2022 Application Instructions and Privacy Notice and Rights and Responsibilities
21-22 final EAP Checklist

* If you have had ZERO income for the past three months, please fill out the PY 2022 Income Verification Affidavit

If you have utilities in rent, you must provide a current lease or PY 2022 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