United Way of Greater Stark County COVID-19 IMPACT FUND
United Way of Greater Stark County is seeking to help those in need of rent or mortgage assistance due to loss of job and/or reduction of hours by the COVID-19 pandemic. Support will be given to those meeting the eligibility requirements and until funding is exhausted.

To qualify for the assistance the following criteria must be met. Please have these items available when an Impact Team member contacts you.
- Must have proof of temporary layoff or job loss as a result of COVID 19 (one of the following 3 work for verification
- A letter from the Ohio Bureau of Unemployment
- A letter, on letterhead from your employer and last paystub – It must have a supervisor or managers name and contact phone number
- A copy of Ohio Department of Job and Family Services Mass Layoff Instruction Sheet (form JFS 00671 rev 3/2020) received from your employer and you must include a supervisor or managers name and contact phone number
- Must reside within the Greater Stark County area
- Must have valid photo ID
- Must have a valid phone number and an email address
- Must have the landlord or Mortgage Company information
- Must have a contact and valid contact phone number
- Must have mortgage account number
- Must have a valid mailing address for mortgage company or landlord

Pictures and/or scans of the items listed above will be requested to be sent via email once approved.

Please answer the below eligibility questions, as well as confirming the releases of information that allows the Impact Team to verify your information with your employer and landlord/mortgage company.

A Impact Team member will review your information and will notify you of your status within 3-7 business days.
Email *
First Name, Middle Initial, and Last Name *
Birthday *
MM
/
DD
/
YYYY
Last 4 SSN *
Home Address, include zip code *
Phone Number *
Were you recently laid off and/or experienced a reduction of hours due to the COVID-19 pandemic? *
Name of Previous Employer *
Date of Layoff and/or Reduction of Hours *
MM
/
DD
/
YYYY
Previous Employer Contact Name & Phone Number *
By checking I Accept, you agree to allow the United Way Impact Team to call your previous employer to verify layoff and/or reduction of hours. Verification is needed to receive assistance. *
United Way of Greater Stark County COVID-19 Emergency Assistance Program will offer a ONE time payment for you rent or mortgage due to loss of job and/or reduction of hours due to the COVID-19 pandemic.
What is the amount owed for your one time assistance with your rent or mortgage? *
Landlord/Mortgage Company Name *
Landlord/Mortgage Company Phone Number *
By checking I Accept, you agree to allow the United Way Impact Team to call your landlord or Mortgage Company to provide payment information. Verification is needed to receive assistance. *
By entering your full name (First, Middle Initial, Last) below, you are agreeing to sign this form electronically. You agree your electronic signature is the legal equivalent of your manual/handwritten signature on this Agreement. *
Thank you for reaching out to United Way of Greater Stark County. We are in receipt of your inquiry for assistance with your rent or mortgage. One of our Impact Team members will contact you within the next 3-7 business days.
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