Bills requested
Rent $500.00
Landlord(405) 111-2222
W-9 required — rent payment
Mortgage $500.00
Mortgage Lender(405) 111-3333
Electric $100.00
Electric Co(405) 222-3333
Gas $100.00
Gas Company(405) 333-4444
Water $100.00
Water Company(405) 444-5555
Other $200.00
Other Company(405) 555-6666
W-9 required — counseling payment
Additional Payment Information
Let us know if this is an urgent request, if there is specific information needed for the check memo line, etc.
Applicant background
Attending Life.Church?
Yes
LifeGroup leader aware?
No
Steps toward employment
Working with a recruiter
Prior financial assistance from LC?
Yes — $500.00 received
Other assistance sources
None
Financial situation
Challenges: Challenges
God moving: Waiting
Willing to share budget: Yes
AP details
AP completed date
2/6/2026
Summary of results
RentApproved$500.00
MortgageApproved$500.00
ElectricApproved$100.00
GasApproved$100.00
WaterDenied$0.00
OtherApproved$200.00