translate Translate
Alert
Evacuation notices have been issued for the areas around the Austin fire READ MORE
click to return to home page

Health Housing and Human Services

Clackamas County Money Management Program

Clackamas County Money Management Program

Extra Spending Request Form

This form is for requesting anything considered “Extra Spending” outside of the customary spending on a client’s budget plan. 

For questions or assistance, please contact us at ommp@clackamas.us or 503- 650-5623.

Indicates required field
$

For any amount over $200.00, proof of purchase receipts are required to be submitted to us prior to being allowed to request additional extra spending.

Payable to:

Requires Payee Disbursement Receipt signed by Client and returned to our office.


Delivery Options


Pick up at our office during normal business hours.


This information is to be filled out by the person submitting the request.

TIMELINE: Requests submitted before Monday at 8 a.m. will be processed for payment on Wednesday after 2 p.m. of the same week. If client has a debit card, it will be funded the following Monday. For requests received after the deadline, the funds will be processed the following week.


I have receipts FOR THIS request, and am uploading them now. (Allowed upload types are: PDF files, and Images such as PIF, JPG, PNG)
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.