Military service verification is required for all applicants. Please upload a copy of the veteran's DD214 and a valid government-issued photo ID. All documents are kept in strict confidentiality and used only to verify eligibility.
Applicant's Relationship to Veteran * Select relationship I am the Veteran Spouse of Veteran Dependent / Child of Veteran Caregiver of Veteran Gold Star Family Member
Monthly Household Income * Select range No current income Under $1,000/month $1,000 – $2,000/month $2,000 – $3,000/month $3,000 – $4,000/month Over $4,000/month
Upload Government-Issued Photo ID * Please describe your current hardship and why you are requesting assistance *
Please select all types of assistance you are requesting. CVF pays vendors directly — we do not provide cash. Grocery assistance is provided in the form of a gift card. Please note that CVF will do its best to fulfill your request but reserves the right to approve partial assistance based on available funds.
If other — please describe (optional)
🏠 Landlord / Property Management Information Required if requesting rent assistance. CVF pays landlords directly.
⚡ Utility Provider Information Required if requesting utility assistance. CVF pays utility companies directly. Please complete for each utility.
📋 Other Vendor Information Required if requesting other assistance. CVF pays vendors directly — no cash payments to applicants.
📋 Please Read Carefully Before Signing 1
No Cash Payments: CVF does not provide cash payments directly to applicants under any circumstances. All financial assistance is paid directly to landlords, utility providers, and other vendors on the applicant's behalf. Grocery assistance is provided in the form of a gift card only.2
Partial Assistance: CVF reserves the right to approve partial assistance based on available funds. Submitting this form does not guarantee that the full requested amount will be provided.3
No Guarantee of Assistance: Submitting this application does not guarantee assistance. CVF will review each application based on available resources and community need. A CVF representative will contact you to discuss your request.4
Truthful Information: All information provided on this form must be accurate and truthful. Providing false information may result in disqualification from assistance and may affect future eligibility.5
Strict Confidentiality: All information provided on this form is kept in strict confidentiality and will not be shared without your permission except as required by law or in cases of immediate safety concern.6
Military Verification Required: A copy of the veteran's DD214 and a valid government-issued photo ID are required to verify eligibility. Applications without these documents cannot be processed.