Coronavirus Relief Assistance (CRA) Application

THE CRA APPLICATION IS NOW OPEN

If you have previously submitted a fully completed CRA Application after March 1, 2021, qualified applicants will be contacted for further assessment. If you do not receive a call or email directly from United Way’s Outreach team, your application either did not meet CRA qualification requirements or due to the August 2021deadline and overwhelming application submissions, we were unable to fulfill all emergency assistance requests.


*Incomplete applications will not be considered and follow-up assessment calls will not be made.

*Only outstanding bills that are either past due or within 10 days of being due will be considered.

*All required submitted documents will be verified for authenticity. Forged or fraudulent documents will be reported to the Hernando County Sheriff's Office.

*Please note: If you were a previous recipient/applicant of CRA Hernando CARES from October to December 2020, that does NOT automatically qualify you for CRA Hernando CARES funding in 2021.


United Way of Hernando County was recently awarded Federal Funds through the Hernando CARES Community Safety & Improvement Initiative (Coronavirus Aid, Relief, and Economic Security Act - CARES Act). These dollars are to be used for necessary expenditures incurred due to the COVID-19 public health emergency.

In hopes of easily and efficiently helping local households prior to the end of August 2021, we ask that qualified Hernando County residents who have been impacted by COVID-19 and left financially behind complete the following application for potential United Way of Hernando County Emergency Coronavirus Relief Assistance (hereinafter “CRA”). This crisis relief fund has been established to assist individuals and families who live in Hernando County and who have experienced an unbudgeted and unexpected expense, a layoff, an unexpected loss of income, or a financial hardship directly related to the 2019-2021 outbreak of the coronavirus.

Each client request/application shall be considered on a case-by-case basis. Only qualified Hernando County applicants will be contacted by the United Way team with further instructions and for appointment scheduling. Should you be contacted, the following documents will be required:

  • Budget Worksheet - Download and fill out
  • Picture ID
  • Paystubs documenting reduction of hours or pay, proof of layoff or business closure (if applicable)
  • Bank statements dating as far back as March 2020 (if applicable)
  • SSI statement, Pandemic unemployment statement, or proof of outside income (if applicable)
  • Statement of bill, eviction notice, or foreclosure notice (if applicable)
  • Medical records documenting a mandatory quarantine (if applicable)
  • Signed lease or mortgage agreement for rental assistance cases, as well as completed W9s for landlords in rental assistance cases (if applicable)
  • Social security number
  • Mortgage holder release of information form (if applicable)

All requested required documents must be submitted in order for your case to be approved. 

The CRA is not a supplemental health insurance and shall not be used to pay any medical expenses. 

HERNANDO RESIDENT INFORMATION

Physical Address:
Have you ever served in the military?
Have you previously submitted a United Way of Hernando County CRA application?
Were you a recipient of United Way of Hernando County’s CRA program in 2020?
Re-order Gender Age Weight Operations
more items
Please select the race you most identify with:

COVID-19 IMPACT

How were you impacted by COVID-19?
Please select all of the unmet needs you are currently experiencing as a result of COVID-19:
How did you learn about the Coronavirus Relief Assistance (CRA) Application?

INCOME

Main source(s) of income for household:
If currently employed, how would you identify your work industry?
Does your employer give you the option to work from home?
Do you currently bank with a financial institution?
Do you believe you fall into the ALICE population, being one crisis away from poverty? (Asset Limited, Income Constrained, Employed)
For more information, visit www.UnitedWayHernando.org/ALICE

ASSISTANCE REQUESTED

Type of assistance requested:

RENT/MORTGAGE

Do you currently live in a:
Do you rent or own the property stated above?
Is the contact listed above your:
$
$
Have you received an eviction notice?
Is your rent subsidized?

UTILITIES

$
Have you received a shut off notice?

OTHER

IF OTHER assistance needed:
$
In the event you are scheduled an appointment with an United Way representative, please indicate which method you would be available to conference with (please select preferred method):
Other Relief Assistance
Have you received or do you anticipate receiving any other local, state, federal, or private financial assistance related to the impacts of COVID-19?
Including but not limited to: Economic Impact Payment (stimulus payment), Pandemic Unemployment Assistance, funding through any other CARES Act program from another local agency, or private insurance. 

Please note, by selecting YES, this does not disqualify you from receiving assistance through United Way's CRA.

If Yes, please fill out the following information below:

Source of Funds #1
Source of Funds #2

ACKNOWLEDGEMENT AGREEMENT

Under penalties of perjury, I declare that I have read the foregoing application and that the facts stated in it are true. I further understand that, pursuant to Section 92.525, Florida Statutes, a person who knowingly makes a false declaration thereunder is guilty of the crime of perjury by false written declaration, a felony of the third degree, punishable as provided in Sections 775.082, 775.083 or 775.084, Florida Statutes.

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