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earpdocs@montgomerycountymd.gov

Emergency Assistance Relief Program (EARP)

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Introduction

The Emergency Assistance Relief Payments program (EARP) provides immediate financial assistance to low-income households who are either (1) not eligible for federal or state COVID-19 aid or (2) had a household member test positive for COVID-19. The program issues checks or debit cards worth between $250 and $1950 to qualified households. 

Before starting this application, please confirm you have the following in hand (digital scans):

Who is completing this Form?

Agency Selection

Agency Representative Full Name

Let's Check if you are Eligibile

Have you had a positive COVID-19 test since September 1?

Have you received -- or do you qualify for -- state unemployment benefits or the federal tax stimulus check?

Please proceed

You do NOT qualify for the EARP program based on eligibility for other benefits. EARP is for residents without access to other benefits.

Based on the number of people in your household, was your income below the limit in the table below?

HOUSEHOLD / FAMILY SIZE: 1 2 3 4 5 6 7 8+
MAXIMUM MONTHLY INCOME: $1,595 $2,155 $2,715 $3,275 $3,835 $4,395 $4,955 $5,515

Please proceed

You do NOT qualify based on income.

Have you received a County check in the past few months for the "Emergency Assistance Relief Payment" program (between $500-$1450)? DHHS will check for duplicate submissions.

You continue to be eligible for another EARP payment based on your COVID-19 positive result, but your payment amount may be reduced. Please proceed.

Have you already received a County check in the past few months for the "Emergency Assistance Relief Payment" program (between $500-$1450)?

Please proceed

You do NOT qualify to submit a second request for an EARP benefit. EARP recipients are automatically considered for a second payment.

If you received only GREEN positive feedback, please proceed. If you received a RED warning in response to your answers above, you are NOT qualified for this benefit -- please do NOT proceed.

Applicant Information (Information about You)

Please list your name (i.e. the name of the applicant / head of household) exactly as it appears on your ID.

Home Address (ex: 401 Hungerford Dr, Rockville, MD 20850 -- if you have an apartment number, please list that in the next question instead)

    Date of Birth

    Ethnicity (for statistical reporting only)

    Gender

    Information about your Needs and Preferences

    Preferred Payment Type

    Other Needs

    By selecting the boxes above, you consent to your contact information being shared with other programs to provide you with information about -- or to connect you to -- additional services. Checking the boxes is not a guarantee of service.

    Information About Other Household Members

    Please provide the name, date of birth, gender, and relationship for each of the other members of your household. Other members of your household include your children, your partner (if filing taxes jointly), and any other members who depend on you financially or who you share your finances with. Please list children first.

    Are you applying as an individual or as part of a family / larger household?

    Thank you. You have completed this section. Please click the "Next" button on the right to proceed.


    HOUSEHOLD MEMBER 2 (Please do not list yourself; this is for the second household member you would like to list)

    Household Member 2 - Date of Birth

    Household Member 2 - Gender


    Do you have a third household member to include?

    Household Member 3 - Date of Birth

    Household Member 3 - Gender


    Do you have a fourth household member to include?

    Household Member 4 - Date of Birth

    Household Member 4 - Gender


    Do you have a fifth household member to include?

    Household Member 5 - Date of Birth

    Household Member 5 - Gender


    Do you have a sixth household member to include?

    Household Member 6 - Date of Birth

    Household Member 6 - Gender


    Do you have a seventh household member to include?

    Household Member 7 - Date of Birth

    Household Member 7 - Gender


    Do you have an eighth household member to include?

    Household Member 8 - Date of Birth

    Household Member 8 - Gender

    Eight is the maximum number of reportable household members. You do not need to list additional household members. 

    Upload Supporting Documentation

    Please submitt all required documentation for your case to be reviewed and processed in a timely manner:

    Submit Document: Lease or Rental Agreement (signed letter from person being rented from)

    Submit Document: Child/Children Relationship Verification (e.g. Birth Certificate, School Report Card, Doctor Visit Notification)

    Submit Document: Income (Paystub)

    IMPORTANT: To protect your personal information, please submit an email with a scanned copy of your personal identification (Driver License or Passport) to EARPdocs@montgomerycountymd.gov.This is REQUIRED to complete your application. We cannot process your information without this emailed document.

    *Please include Application number in your email.

    Applicant Consent, Confirmation, and Signature

    I request that my family (or I am signing on behalf of a client) be referred to Emergency Assistance for Residence Program (EARP) for emergency assistance. I attest that I am NOT eligible for Maryland unemployment insurance or for the federal stimulus payments administered by the IRS, unless COVID+. I have NOT yet obtained or been referred to this emergency assistance by any other organization. I also confirm the accuracy of information entered above, including my household income, household composition, and County residency. I understand that my information will be entered in the Emergency Assistance Platform (EAP) and will be shared only with authorized EARP personnel. I further understand that I am responsible to inform my referring agency if my situation changes, such as my address or contact numbers.

    I swear (or affirm) that all information on this application is true, correct and complete to the best of my ability, knowledge and belief.

    Sign Here

    Choose how to sign

    Application Number

    You will be provided with a Application Number upon submission.

    NOTE: After you click on Submit - keep the receipt numbers for your records. You will be given the option of downloading a PDF version of your application - please download as you cannot access this application after submittal.