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  1. The Emergency Food Assistance Program (TEFAP) commodity food is distributed on a monthly basis to qualified low-income Livonia residents based on their total household income and residency. Residents who receive SSI, Bridge Card or Medicaid benefits are automatically eligible. Those receiving all other sources of income must qualify based on federal income guidelines.
  2. In order to be eligible for the program you must meet the eligibility guidelines and submit an application along with proof of income and Livonia residency. For further information, please call (734) 421-6450 ext. 105
  3. General Information
  4. Preferred Method of Contact*
  5. Household Members
  6. Housing Type*
  7. Assistance Received*
  8. Income
  9. List all income for everyone in the household. (Example: Social Security, Pension, Unemployment Benefits, Wages, SSI, SSD, Child Support, Income from Rental Property, Land Contracts, Self-Employment, Etc.)
  10. Do you need help with a Utility Shut-off Notice?*
  11. The City of Livonia Housing Commission provides eligible low/moderate income residents with utility (gas, electric, or fuel heating) shut-off assistance when a “SHUT-OFF” notice has been received from the utility company.
  12. • Up to $500 may be available to those who meet eligibility requirements
  13. • Funds are given on a ONE-TIME only basis
  14. • Applicant must be occupant at the address of the shut-off/disconnect notice with utility service in their name
  15. • Income limitations and other restrictions apply
  16. Are you interested in receiving mental health counseling services?*
  17. We also provide financial assistance to income eligible Livonia residents to obtain professional mental health counseling services. The financial assistance provided is as follows:
  18. • $400 in assistance per year, per eligible family/household
  19. • $80 per counseling session
  20. • A minimal Co-Pay, based on income, will be required per visit
  21. How did you hear about us?*
  22. Electronic Signature Agreement
    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.
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  24. This field is not part of the form submission.