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2. The Fairview Residential COVID-19 Relief Program – Round II is designed to be utilized by households that have not received other compensation to fully recoup their loss of income due to the financial impacts of COVID-19.
   
   To be eligible, the residence must be within the City of Fairview or in an unincorporated area of Multnomah County that is served by a Fairview residential utility account. If approved, households who meet the criteria may be granted assistance of up to $265. Only one award per physical address will be granted. Assistance will be via Fairview utility account credit unless the residence does not have an individual Fairview utility account. In this case, the assistance will be disbursed via check. If you have already received utility assistance through the prior City program but have not fully recouped financial losses due to COVID-19, please apply for Round II of the assistance program as well.
   
   If you need assistance completing the online application or would like a paper application, please contact the City Recorder at 503-674-6224 or email leymasterd@ci.fairview.or.us.
4. Frequently Asked Questions
   FAQs - Residential Relief Program
6. Date of Application*
   Date of Application
8. Applicants Name*
10. Physical Address*
12. Mailing Address (if different from above)*
14. Daytime Phone Number:*
16. Email Address*
18. How has COVID-19 negatively affected your household financially?*
20. Does your residence have Fairview utility account?*

    1. Yes
    2. No
22. If yes, what is the utility account number?*
26. Affidavit of Program Eligibility and Relief Use
28. By entering your full name as a signature, you attest that you are authorized to apply for relief on behalf of the residence listed above, that the household has not received benefits equal to, or more than, the loss of income due to COVID-19 and that all information provided is true to the best of your knowledge. You understand that funds awarded will be in the form of a City of Fairview utility account credit. If you do not have a City of Fairview individual residential utility account, you agree funds provided to you via check will be utilized for rent relief for the address listed above.
    
    (Completing this application is not a guarantee of assistance. Assistance is based on qualification and available funds.)
30. Electronic Signature*
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31. 1. Receive an email copy of this form.
32. Email address

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33. Submit

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