Application Form For Emergency Relief printable pdf download

APPLICATION FORMS AND PROCEDURES AS OF APRIL 1, 2014

GEORGIA NATIONAL GUARD FAMILY SUPPORT FOUNDATION, INC.

1000 HALSEY AVE., BLDG 447, MARIETTA, GA 30060

678-569-5704 (tel)

WEBSITE:

The Georgia National Guard Family Support Foundation, Inc. is a non-profit 501 (c) (3) charitable corporation established in 1994 for

the primary purpose of providing financial assistance on an emergency relief basis to soldiers and airmen serving in the Georgia

National Guard,

and other qualified military members living in the

federal/state civilian employees of the Georgia Department of Defense

State of Georgia.

Although not a military organization, the Foundation is recognized as an official support organization of the Georgia National

Guard.

Applications should be verified as an EMERGENCY situation and the UNIT VALIDATION CERTIFICATION MUST BE SIGNED

by the Commander or a full-time unit member designated by the Commander; the First Sergeant; the Administrative Officer

or the Readiness NCO and be scanned to:

harriet.h.morgan.civ@mail.mil

Emergency situations include, but are not limited to, payments to avoid eviction or foreclosure, utilities to prevent disconnection,

vehicle payments to prevent repossession, temporary pay problems, illness, injury, recent loss of employment, natural disaster or

destruction of property by fire , water or other man-made destruction. The fund is not intended for long-term or recurring financial

support. Neither is the fund to be used to alleviate situations caused by failure to follow proper routine pay procedures. Eligibility

requires that applicant must be MOSQ/AFSC Qualified and assigned to a MTOE/TDA or ANG UNIT and must be receiving UTA

or ADOS pay from their assigned unit for a minimum of three consecutive months.

(Soldier’s or Airmen assigned to an RSP or

student flight are not eligible for assistance)

Two types of requests for EMERGENCY RELIEF ASSISTANCE are available: GRANTS or LOANS

GRANTS are considered when applicants are faced with extreme financial hardship and do not have the ability to repay a

Loan. Grants do not have to be repaid.

LOANS are considered when a financial hardship is temporary in nature, such as, a military pay problem or delay.

Guard members/employees will be required to sign a non-interest-accruing promissory note with a specified repayment plan.

Interest free Loans must be repaid, usually by ACH Debits, from your checking or savings account.

Please Note:

If a LOAN account is insufficient and a payment is returned, a $25.00 penalty fee will be charged.

If a LOAN account is insufficient twice in succession or the account is closed without notification to the FOUNDATION,

the ACH Debit process will be stopped and the loan will be called due and payable in full, including the penalty fees.

In all cases, APPLICANTS are encouraged to contribute to the FOUNDATION when their financial situation improves. In this way,

Georgia National Guard Members, their families and other qualified military members living in the State of Georgia can be helped during

financial hardship. You can make a tax-free donation at our website: ; when filing your State of Georgia Tax

Return; through the Combined Federal Campaign (CFC # 70602), the State Charitable Contributions Program (SCCP 177000), or simply

by mail. All support is recognized and appreciated.

INSTRUCTIONS:

•

Applicant must complete the application form in its entirety.

•

Unit Validation Certification must be completed and signed by the proper chain of command.

•

Include copies of actual bills requested to be paid by the Foundation with the completed Application.

•

Authorization Agreement for Direct Payments (ACH Debits) must be completed and signed with Bank Depository Name and

a VOID CHECK, OR a Bank Statement must be attached with applicant’s name, address, routing number for debits, and

account number.

CALL 678-569-5704 IF YOU HAVE ANY QUESTIONS ABOUT THIS APPLICATION.

SCAN COMPLETED APPLICATION TO:

harriet.h.morgan.civ@mail.mil

THE GEORGIA NATIONAL GUARD FOUNDATION BOARD REVIEWS APPLICANT’S INFORMATION

AND RESERVES THE RIGHT TO VERIFY ANY INFORMATION PROVIDED.

01 APRIL 2014

PAGE 1 OF 3

Application Form For Emergency Relief

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