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Town of Lexington Human Services Department

39 Marrett Rd. Lexington, MA 02421


Application for Emergency Financial Assistance

Applicant: After completing the form a social worker from the Human Services Department will contact you to complete the remainder of the application.

Emergency Financial Assistance is available to Lexington residents through the Lexington Emergency Assistance Fund (LEAF)

What is LEAF?

LEAF is a collection of funds specifically setup to provide financial assistance to Lexington residents experiencing an unexpected financial crisis. LEAF can provide limited financial help for critical needs when other funding sources are unavailable or have been exhausted.

To be eligible, you must:

  • Be a resident of Lexington for at least 3 months.
  • Provide proof of residency and income, and other information as requested to complete your application.
  • Have a household income that is within these Assistance Income Guidelines (PDF).
  • Develop a plan for how you will manage financial needs in the future with a Human Services Department Social Worker.

Application Process

  • A Human Services Department Staff member will contact you to complete a financial assessment and gather any additional documentation for the application.
  • An internal team reviews each application. If approved, the situation is presented to the funding source for final approval, keeping your identity private. All decisions are made on a case-by-case basis.
  • Approved funds are distributed directly to the entity requiring payment.
  • The Staff member will also work with you to connect you with other supports.
If you have questions or need other help/services, contact Human Services at or 781-698-4840.

Demographics and Reason for Need (to be completed by applicant):

Full Name:

Full Address:

Length of Residency in Lexington in Years/Months:

Residency Type:

List all people in the Household with Dates of Birth:

Household member #1

Date of Birth #1:

Household member #2:

Date of Birth #2:

Do you need to add more household members?:

Household member #3:

Date of Birth #3:

Household member #4:

Date of Birth #4:

Do you need to add more household members?:

Household member #5:

Date of Birth #5:

Household member #6:

Date of Birth #6:

Amount Requested (Subject to funding limits):

Requested for? Select all that apply:

Upload Files. 2 months of the most recent bank statements (proof of income if no direct deposit), proof of residency (driver’s license, utility bill, rental agreement). Must be a resident for at least 3 months to be eligible for financial assistance. Please note that other documents may be requested by staff during the application process.

Click Here to Upload

Monthly Income Information:

Monthly Expenses:

This section is required. If an expense is not applicable simply type in "0" (zero).


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