Form Center

By signing in or creating an account, some fields will auto-populate with your information and your submitted forms will be saved and accessible to you.

Residential COVID-19 Relief Program

  1. The Fairview Residential COVID-19 Relief Program is designed to be utilized by households that have not received other compensation to fully recoup their loss of income due to the impacts of COVID-19. The "loss of income" under which the residence is applying must have occurred between March 16, 2020 (the date the City declared an emergency) and the date of this application. 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, a credit of up to $252 will be applied to the residential utility account (a credit of up to $63 per month to be determined by actual base utility fees for water, sewer, and storm water service, for up to four months).

    Households who meet the above criteria but do not have a Fairview residential utility account may be granted assistance via check to be used for rent relief (E.g. residents that live in apartments).

    If you need assistance completing the online application or need a paper application, please contact the City Recorder at 503-674-6224 or email leymasterd@ci.fairview.or.us

  2. Does your residence have Fairview utility account?*

  3. Affidavit of Program Eligibility and Relief Use

  4. 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 in excess of, the loss of income due to COVID-19 and that all information provided is true to the best of your knowledge. You further attest that you have the documentation to support and verify your claim and will provide the information to the City upon request. Additionally, if you do not have a City of Fairview residential utility account, you agree funds provided to you will be utilized for rent or mortgage relief for the address listed above.

    (Completing this application is not a guarantee of assistance. Assistance is based on qualification and available funds.)

  5. Leave This Blank:

  6. This field is not part of the form submission.