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Helping Hands Outreach Center of Gasconade County

HHOC Proxy Application Form

Head of Household

(* Required)

Today's Date
First Name *
Last Name *
Street Address *
City *
State *
Zip *
Phone *
# in Household

Household Member(s)

I Certify to the Following...
  • All Members of My Household are Residents of Missouri
  • All Household Members Receive Some Form of Public Assistance or Have a Combined Gross Income as Listed Above
  • Members of My Household Have NOT Received TEFAP Commodities During the Current Month
Head of Household Signature (please type) *
List the full name below to pickup my TEFAP commodities for the current month.
Full Name *
I Understand the following...
  • I May Be Prosecuted Under Current Laws for Accepting Food for Which I Am NOT Eligible
  • Foods May NOT Be Sold, Exchanged or Otherwise Diverted From My Household Use

Helping Hands Outreach Center

3522 Kosark Road
Owensville, MO  65066
Phone:  573-437-8880
Fax:  573-437-8880
Email:  infohhoc@gmail.com

Hours of Operations

Tuesday:  10:00 AM-2:00 PM
Wednesday:  10:00 AM-2:00 PM
Thursday:  10:00 AM-2:00 PM
First Saturdays:  10:00 – Noon
Mobile Market:  4th Friday 11:30 – 1:30

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Helping Hands Outreach Center of Gasconade County | All Rights Reserved.