ALICE Emergency Fund Application | United Way of Central Illinois

The ALICE (Asset Limited Income Constrained Employed) Emergency Fund provides one-time financial assistance to eligible working households who have experienced a significant financial hardship resulting in at least a 30% loss of income or a 30% increase in essential expenses within the past 180 days.

This is a referral only program and requires applicant to have been referred by either the Housing Helpline or your employer.

Our goal is to review and provide a determination within 2 business days of receiving a completed application.

Important Notes:

Applications without required documentation will not be processed.
Submission of this application does not guarantee approval or payment.
If approved, assistance is limited to a one-time payment. No additional support will be available from this fund.

For help completing this form or uploading documents, please contact: Karen Gedrose at kgedrose@uwcil.org or Chloe Reim at creim@uwcil.org

Disclaimer

By completing and submitting this application, you voluntarily provide personal and financial information for the sole purpose of determining eligibility and administering assistance through the ALICE Fund. United Way of Central Illinois will take reasonable steps to maintain the security and confidentiality of the information you provide. However, United Way of Central Illinois, its staff, volunteers, and affiliates are not responsible or liable for any loss, unauthorized access, disclosure, or misuse of such information that is beyond its reasonable control.

Eligibility Criteria

You have been prescreened and may be eligible if the following apply (must check all below to proceed):

Reside in Sangamon or Menard County for at least 6 months

Employed or temporarily unemployed due to circumstances beyond your control

Not currently receiving rent/Mortgage assistance from other government, faith-based, or nonprofit organizations.

Experienced a significant financial hardship within the past 180 days, including: 30% or more reduction in household income; Death of a significant other; Divorce or separation; Major injury or medical diagnosis; Loss of primary vehicle used for work/school; Loss of childcare required for work/school

Income is at or below the ALICE Survival Budget limits (see below)

Income Guidelines

Maximum Gross Annual Household Income

Household Size Min Income Max Income

1 Person $20,345 $28,000

2 People $27,495 $43,000

3 People $34,645 $60,000

4 People $41,795 $70,000

5 People $48,945 $84,000

6 People $56,095 $95,000

Household Financial Situation

Explain your household income - What is your hourly wage or salary? What is your estimated annual household income (including income from all adults in the household)?

Describe your household - How many people live in your household? How many adults and how many children?

Emergency Description - Please describe the emergency or situation that led to this request for assistance.

Financial Hardship - How far behind are you on the bill(s) you are requesting assistance for? What is the balance owed? When is the payment due to avoid shutoff, eviction, or other consequence?

Required Documentation

To process your application, you must upload the following applicable documents. All documents must clearly show that the qualifying event occurred within the last 180 days.

Proof of Identity - Government-issued photo ID

Upload requirements

Proof of Residency (Upload One) - current lease agreement, mortgage statement (current month), Utility bill (current month)

Upload requirements

Proof of Income (all income earners in household) - two most recent months of pay stubs; if self-employed - bank statements; child support or spousal support statements (current); retirement or pension statements (current)

Upload requirements

Documentation of Outstanding Expenses - Rent/Mortgage/Essential Bills Copy of current lease agreement Leasing ledger or account statement from landlord/leasing office Bill or invoice from a mortgage lender, childcare provider, care repair quote, other

Upload requirements

Vendor Payment Information

Financial assistance will be paid directly to the vendor (such as your rental company, mortgage company, childcare agency, or car repair company).

In order for payment to be issued, the vendor must provide a completed W-9 form.

Applicants may download the W-9 form here. Please give the form to your vendor for completion.

The vendor should return the completed W-9 form by email to: Kgedrose@uwcil.org

👉 If payment is going to a landlord, the landlord must also complete and sign the Landlord Affidavit Form. Download Landlord Affidavit form here. This form should be returned with their W9.

Vendor Name:

Vendor Phone:

* Applications without required documentation will not be processed.