'County of Primary Residence' and 'Number of total household members' must be selected before options appear here.
Address / Contact Info
You will receive a summary of this application via email as well as a link to look up the status of your
application at any time.
Iowa Workforce Development will use this to verify the eligibility of this application
Please provide the requested information for each member of your household
(including children) even if there was no loss of income for each individual member.
Data for the first member provided below should be for the applicant and should match the data from the previously provided contact info.
This can include manufactured home or lot rent. Please enter dollar amount to the nearest whole dollar (e.g. $425).
If you live with roommate(s), please provide only the rent amount for which you are responsible.
This amount is subject to verification and is not a guarantee of financial assistance.
I certify that the information presented in this application is true and accurate to
the best of my knowledge and belief. I authorize the Iowa Finance Authority and
participating agencies, to verify and investigate such information, including my
legal status to be in the United States, with my full cooperation at any time. I
understand that providing false, misleading or incomplete information may result in
the application being declared void. I understand that it is a criminal violation
under Iowa law to make a false statement in writing for the purpose of procuring
assistance from a state agency.
I understand that all information submitted to IFA related to this application is
subject to Iowa's Open Record Law (Iowa Code, Chapter 22). Furthermore, I am aware
that funds will not be disbursed until I have been determined to be eligible and my
landlord has submitted the proper certification.