Discharge must be honorable/General/General under Honorable Conditions
*PLEASE SEE POLICIES AND PROCEDURES FOR ALL REQUIRED ELIGIBILITY DOCUMENTATION.
I have no assets or other resources to meet the needs identified above. I have been a resident of Washington State for at least one year and live in Clark County. I certify that the information I have provided is complete and accurate. I understand that I may be subject to criminal prosecution if I have knowingly provided false information.
I give my permission for this agency to request/release information necessary to receive benefits from this request. I further give my utility vendor and landlord permission to release my account information to the agency. I understand assistance is in the form of vouchers or direct payments to vendors.
I, attest that I will not use my Winco/Chevron gift card for any other purpose, but to purchase food, personal hygiene items, toiletries, baby items, pet food and fuel.
Food/Gas vouchers may not be used for alcohol, tobacco, or lottery products.
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