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Ashley Gipson

NAMES + AGES OF PEOPLE IN HOUSEHOLD

me - 27 years old

EMPLOYMENT STATUS OF ADULTS LIVING IN HOUSEHOLD

Unemployed

IF NOT WORKING, PLEASE EXPLAIN WHY.

I am unemployed due to health issues that led to job loss. I am currently enrolled in a CNA course, have interviews lined up, and expect to be certified by April.

HAVE WE PROVIDED ASSISTANCE BEFORE? WHEN?

no/not to my knowledge

ADDRESS FOR ASSISTANCE REQUEST

126 S Franklin St, Madison, WI 53703, USA

PHONE NUMBER

6085041545

WHAT IS YOUR REQUEST FOR?

DISCONNECTION NOTICE?

No

DISCONNECTION DATE

3/19/2026

LANDLORD CONTACT/UTILITY COMPANY INFO

Park Central - Phone number is 608-467-2001

REQUEST AMOUNT

549.25

TOTAL AMOUNT DUE

549.25

BALANCE AMOUNT OWED

549.26

OTHERS PROVIDING ASSISTANCE

No others, the vine churcch is helping with food.

ADDITIONAL INFORMATION

I am working to regain financial stability, building an emergency fund once employed. Currently receiving only food support from my church.

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