Financial Assistance

Helping families in crisis.

Society of Samaritans

SOS Financial Assistance

Please carefully review the Financial Assistance Checklist and provide all listed documents with your Application and Release forms. Please be sure to complete the Additional Household Members form for each other member of the household (two people on each page). Email all documents to FinancialHelp@societyofsamaritans.org and we will respond to you within 48 hours.

If you're not able to complete the forms online, please call our office at +1 (281) 259-8452 to make an appointment to come in to complete them and turn in your required documentation.

Financial Application Checklist

Download

Client Application and Release Form

STOP and read these instructions:

Please fill out this form on your device, and then save it onto the device. To send it to us, please attach the saved file onto your email addressed to FinancialHelp@societyofsamaritans.org

Download

Additional Household Members

STOP and read these instructions:

Please fill out this form on your device, and then save it onto the device. To send it to us, please attach the saved file onto your email addressed to FinancialHelp@societyofsamaritans.org

Download

Household Income Worksheet

STOP and read these instructions:

Please fill out this form on your device, and then save it onto the device. To send it to us, please attach the saved file onto your email addressed to FinancialHelp@societyofsamaritans.org

Download

Blank W-9 Tax Form

STOP and read these instructions:

If you need help with rent, we need a copy of your lease, a statement from your landlord of the total balance of rent due, and a W9 form completed by your landlord. Attach all of the documents to one email and send it to FinancialHelp@societyofsamaritans.org

Download