Application in English
Household Income Documentation Required: (MUST BE PROVIDED TO PROCESS)
• Tax Return from the prior year (Form: CT-1040)
Note: If any minor dependent living in the household is not listed on the 1040 tax return, a birth certificate is required. Additionally, anyone not on the tax return will be removed from the application and will have to apply separately.
• 2-3 CURRENT Paystubs.
Note: Applies to all employed household members. If members get paid weekly, the Y will require 4 paystubs. If a member gets paid biweekly, please provide 2 paystubs.
• Social Security Letter (Must be from the current year but not older than 6 months)
Note: Letter can be requested at the Social Security office or by calling Social Security and requesting a letter to be sent to you. If you receive SSI or DSI, no tax return is required.
• Cash Assistance
ADDITIONAL INCOME DOCUMENTATION: *If Applicable*
• Child Support verification for all minor dependents in the household.
NOTE: If no Child Support is received, a letter must be provided from the support enforcement services, stating no pending case. Child Support Enforcement Address: 11 Scovill Street Waterbury, CT, 06706.
• Foster Care Income, if applicable
• Retirement income, if applicable.
• SNAP also known as Food Stamps for all household members receiving them, if applicable
(If you receive SNAP benefits, please provide all pages)
NOTE: You will not qualify if you only receive food stamps.
• DSS awards if applicable (Provide all pages)
• Budget letter from State
If you have any questions about the Open Doors program, please contact the Welcome Center at 203.754.9622 ext 100.