Within the application for assistance (PR-1) is a Consent to the Disclosure of Information. This
form allows the Trustee to contact specifically named collateral sources to verify the applicant’s
circumstances (I.C. 12-20-6-1). The Township Trustee will conduct an investigation and
verification, as soon as possible. The applicant or adult household member may be required to
supply additional information and verifications. Verification procedures will not place unreasonable burdens on the applicants. However, it is incumbent upon the applicant to furnish the township with all information and documentation necessary for determining eligibility (I.C. 12-20-6-7b). Only after the completion of all investigation and verification will assistance be granted to those who qualify.

(1) The Trustee may require a home visit to verify the following:

(a) Composition and identity of all members of the household.

(b) To verify the property is not in violation with the city building codes
or the Board of Health.

(c) Current residence, if any.

(2) Social Security numbers of all members of the household

(3) Employment or loss of employment of all members of the household.

(4) Income and available assets or resources of all members of the household.

(5) Application for or receipt of other public assistance for which the trustee believes the applicant
or members of the household may be eligible.

(6) Picture ID’s or Driver’s license for anyone in the household 18 years or older in the household.

(7) Birth Certificates for everyone in the household.