HomeSafe Application

Phone Type *
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RI resident for the last 365 days? * 🛈
Please be ready to provide proof of a DV situation, such as a waiver or police report.


Please upload the past 2 months of bank statements for each adult living in the household






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Please upload SSI/SSDI award letters for each disabled household member




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I need financial assistance with: *









What type of assistance did you apply for? *
Were you funded? *
I certify truthful information * 🛈
I agree to application review * 🛈
I authorize contact with my creditor * 🛈
I understand any payment is to creditor * 🛈