1. Enter the account holder's first name, last name, and address in the designated fields. Note 2 : This is a sample document for reference only.A release letter should show the contract's actual end date and include the final payments you gave your domestic helper. Find Local Rules and Forms that provide procedures and guidelines for courts in Mecklenburg County. Note 2 : This is a sample document for reference only. Use funds in the form of a personal check, money order or cashier's check. Said funds must come from a US (domestic) bank and must be payable in US dollars. A restraining order that is designed specifically for victims of domestic violence to give them the protection they need from the abuser. Imminent utility cut-off; Inoperable or unsafe heating equipment. A complete list of eligibility requirements may be found in the EAP manual.