Correspondence (e.g. completed forms) may be dropped in the voting ballot box in the south parking lot at the Courthouse (13 W 3rd, La Junta). 

 

ADULT SERVICE FORMS AND INFORMATION

  • Use "AAA_C2" form for meals for clients over age 60.  Residents of Baca, Bent, Crowley, Kiowa, Otero, and Prowers Counties are eligible.
  • Use "COVID-19 Assistance" form to apply for assistance (groceries, utilities, rent, etc.) due to COVID-related situations .  Must be a resident of Otero County.
  • Use "CSBG" form to apply for assistance with utilities, essential appliances (e.g. water heaters), and for meals if under age 60.  Residents of Otero, Crowley, and Bent Counties may be eligible.

Forms are posted below to allow you to view the form while completing the information with a live Adult Services representative.

Please call 719-383-3173 or 719-383-4844 to complete and submit the forms by phone.  
Filename Size Date & Time
An Adobe Acrobat file AAA_C1_APPLICATION_for_Meals_for_60_without_ADLs 235.2 KB 2020-03-27 10:13:59
An Adobe Acrobat file AAA_C2_APPLICATION_for_Meals_for_60_with_ADLs 164.73 KB 2020-05-13 15:28:43
An Adobe Acrobat file COVID-19 Assistance App 132.89 KB 2020-05-05 10:03:53
An Adobe Acrobat file CSBG APPLICATION for COVID-19 Assistance 388.84 KB 2020-05-05 10:49:50

 

ANNEX FORMS AND INFORMATION

 Please call 719-383-3100 if you need local assistance.  
Filename Size Date & Time
An Adobe Acrobat file Application_For_Public_Assistance 1.13 MB 2020-03-31 15:06:01
An Adobe Acrobat file Application_Info_Flyer 308.76 KB 2020-03-30 15:55:41
An Adobe Acrobat file Authorization_to_Release_Information 23.28 KB 2020-03-30 15:56:07
An Adobe Acrobat file Burial_Application 1.6 MB 2020-04-08 10:30:40
An Adobe Acrobat file Child_Support_Application_11-2019 439.24 KB 2020-03-30 15:56:18
An Adobe Acrobat file Child_Support_Services_Review_Request 1.02 MB 2020-03-31 15:05:24
An Adobe Acrobat file Food_Stamps_Change_Report_Form 3.17 MB 2020-03-30 15:56:36
An Adobe Acrobat file Request_for_LTC_Services 42.86 KB 2020-03-30 15:56:44
 

 

Additional forms and information will be added as we are able.  Thank you for your patience.