Organization Financial Assistance Request




















The beneficiary organization must be located in our 20-county Northeast Ohio service area. Those counties are: Ashland, Ashtabula, Columbiana, Cuyahoga, Erie, Geauga, Holmes, Huron, Lake, Lorain, Trumbull, Mahoning, Medina, Ottowa, Portage, Richland, Sandusky, Stark, Summit, and Wayne.
















NEOPAT cannot issue a check directly to an individual. Rather, the payee must be a separate entity related to either an attachment included with this request or some other documentation.


If specific payments are being requested, please include the full name, mailing address, and account number (if applicable) of one or more of those payees.




If you have a specific dollar amount need relating to a bill, invoice, etc., please attach it here. Up to 10 attachments may be added.








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