Get Critical Care & Funeral Assistance Application - Samuel Simmonds ...

Filling out the Critical Care & Funeral Assistance Application is an important step in accessing necessary assistance for medical or funeral crises. This guide will provide you with a step-by-step approach to ensure that you complete the application accurately and efficiently online.

Follow the steps to complete your application accurately.

1. Click the ‘Get Form’ button to access the application form online and open it in your preferred editor.
2. Begin by identifying the type of assistance you are applying for. You need to select between funeral expenses, funeral travel, or critical care travel.
3. Fill in your personal information, including your first name, middle name, last name, date of birth, and social security number as shown on your identification.
4. Indicate if you have been known by any other names and provide these details if applicable.
5. Confirm your eligibility by answering questions regarding your residency in North Slope Borough and if you are an Arctic Slope Regional Corporation shareholder.
6. Provide information about the deceased family member, including their name, relationship to you, and whether they were a U.S. veteran or a North Slope resident.
7. Describe your situation and state clearly what assistance you require from ASNA.
8. List all earned and unearned income for all adults in your household for the past 12 months, ensuring that you include all relevant sources of income.
9. Complete the section listing everyone in your household, including children or dependents, and provide their full names, dates of birth, social security numbers, relationship to the applicant, annual income amounts, and sources.
10. Read and sign the certification statement, confirming that all information provided is true to the best of your knowledge. If applicable, a parent or guardian must sign if the applicant is a minor.
11. After completing the application, you can save your changes, download the completed form, print it, or share it as required.

Complete your application for the Critical Care & Funeral Assistance online to access the support you need.