Dekalb County General Assistance

DEKALB COUNTY DEPARTMENT OF FAMILY AND CHILDREN SERVICES

2300 NORTHLAKE PARKWAY | ATLANTA, GA 30345

Georgia Department of Human Services

Dekalb County Family & Children Services - Region XIV

2300 Northlake Parkway, Atlanta, GA 30345  404-370-5000

Dekalb County General Assistance

The DeKalb County Department of Family and Children Services (DFCS) currently has funds

available to assist households who have experienced an unexpected, uncontrollable, one

time crisis or emergency that has prevented the applicant from paying their utilities or rent.

Applicants must demonstrate that they are facing disconnection of utility service ( i.e. gas,

electricity or water) or eviction from their residence.

Who is eligible to apply?

A. You must be a resident of DeKalb county.

B. One or two parent household with minor children under the age of 18.

C. You must have consistent, verifiable income (wages, child support, social security,

unemployment).

OR

D. Elderly (60 and above) and/or receiving VA or Social Security Disability.

E. Experiencing hardship due to a natural disaster or pandemic.

F. In order to apply for assistance, the following criteria must also be met:

1) For utility assistance, the account MUST have a past due balance OR be in a

disconnect status.

2) For rental/mortgage assistance, we MUST have a DeKalb County warrant OR late

notice from apartment complex/landlord OR Mortgage Company which provides

the following information:

• Applicant name shown as the renter/lease/homeowner.

• Applicant is behind in rent/mortgage and eviction is imminent.

• Itemized list of charges including any late charges or miscellaneous

expenses.

• Handwritten notices are NOT accepted.

DEKALB COUNTY DEPARTMENT OF FAMILY AND CHILDREN SERVICES

2300 NORTHLAKE PARKWAY | ATLANTA, GA 30345

3) Applicant must have verifiable income to show that they will be able to pay their

household expenses for the following month.

4) Applicant must have a valid and verifiable unforeseen emergency that prevented

them from paying the bill. Specific case circumstances will be reviewed on an

individual basis to determine eligibility. If needed, verification will be requested by

the case manager.

G. Verification documents needed in order to process the emergency assistance

application:

1) Current Past Due or Disconnection notice, Current late notice from mortgage

company/landlord or dispossessory warrant.

2) Valid/Current Government issued Photo ID for applicant

3) Income verification for all household members- 2 months of income.

4) Additional Verification: contact phone numbers, household bills, receipts to

validate the reason for being delinquent if applicable. Other items are requested

as needed on a case by case basis.

DEKALB COUNTY DEPARTMENT OF FAMILY AND CHILDREN SERVICES

2300 NORTHLAKE PARKWAY | ATLANTA, GA 30345

GENERAL ASSISTANCE APPLICATION

Georgia Department of Human Services

Dekalb County Family & Children Services - Region XIV

2300 Northlake Parkway, Atlanta, GA 30345  404-370-5000

DeKalb County Department of Family and Children Services (DFCS) currently has funds available to assist

household who had an UNEXPECTED, UNCONTROLLABLE, ONE TIME CRISES OR EMERGENCY that prevented

them from paying their utilities or rent. Applicants must now be facing disconnection of utility services (gas

electricity or water) or eviction from their rental residence with a Dispossessory Warrant signed by a Judge.

Name of Applicant (Please Print)

Date of Application

Client must meet all of the following eligibility requirements to be considered for General Assistance:

However, meeting the application requirements does not mean that you will or will not be eligible for the

General Assistance program.

Please Check Appropriate Box

Yes

No

Are you a State of GA employee? _________ If yes, what division:___________________________

Are you a Dekalb County Resident?

Do you have minor children (under 18yrs) living in your household?

Are you at least 60 years of age or disabled? (VA, Social Security Disability/RSDI)

Are you homeless?

Do you have consistent income in your home? (Wages, Child Support, Disability, Social Security or

Unemployment Benefits)

What Are You Applying For? Please Check YES for the Program Applying For.

Yes

No

Rental Assistance

Are you applying for Rental/Mortgage Assistance? If so, Do you have a Dispossessory Warrant or Late

Notice?

Utility Assistance

Are you applying for Utility Assistance? If so, Do you have A Past Due Balance or a DISCONNECT notice from

the service provider with a scheduled disconnect 15 days from the application Date?

Yes

No

Do you have any cash on hand?

Is there anyone keeping cash for you? Whom?____________________ How much?______________

Do you own an automobile? If yes, Year_________ Make_______________ Model__________

Do you receive Child Support? If yes, how much?_____________ How often paid?______________ Monthly

 Weekly  Bi-weekly  Semi-Monthly 

DEKALB COUNTY DEPARTMENT OF FAMILY AND CHILDREN SERVICES

2300 NORTHLAKE PARKWAY | ATLANTA, GA 30345

Please explain you unexpected, uncontrollable, one-time crisis or emergency that happened in the past 30

days that prevented you from paying your bill. Please be as detailed as possible. Your case situation will be

reviewed along with verification to determine eligibility. You must complete this page, or your application

will be denied for being incomplete.

__________________________________________________________________________________________

Please check Appropriate Box

Veteran  Male  Female  Married Single Divorce Do

you receive any of the following?

Food Stamps Medicaid Subsidized Childcare (CAPS) TANF Section 8

DEKALB COUNTY DEPARTMENT OF FAMILY AND CHILDREN SERVICES

2300 NORTHLAKE PARKWAY | ATLANTA, GA 30345

Name

Social Security Number

Phone Number:

Date of Birth:

Street Address (Apt #):

City, State & Zip Code

Email Address:

Income:

Please list ALL members of your household, including Yourself & all minor children:

Name

Birth Date

Relationship

Monthly Income

Source of income

(wages, SSI, SS, Child Support)

Expenses: You MUST complete this section fully.

Bills:

Amount Due

How often paid

Date last paid

Paid by whom

Rent

Electric Bill

Gas Bill

Cell Phone

Medical Bills

Child Care

Child Support Paid out

Other

Total

Under Georgia law, anyone who willfully makes false statements in order to receive assistance is subject to a

fine and/or imprisonment. Georgia Public Assistance Act of 1965 (act#354 as amended in 1973).

Signature_____________________________________________Date______________________________