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This guide provides a comprehensive overview of how to complete the Assistance Request Application online. Following the steps outlined below will help ensure that you fill out the necessary information accurately and submit it effectively for assistance. Remember, this process supports individuals undergoing treatment for breast cancer in Greater Tulsa.

Follow the steps to fill out your application form accurately.

1. Press the ‘Get Form’ button to access the application form online. This will enable you to open the document in your preferred editing tool.
2. Begin by entering the date on the application form to establish a record of when you submitted the application.
3. Fill in your personal details, including your name, date of birth, mailing address, and contact information. Ensure that all fields marked as required are completed.
4. Indicate your employment status and provide details regarding your monthly income, as well as any other household income sources. This information is crucial for the review process.
5. List the number of adults and children living in your household, and provide relevant details as requested.
6. Answer the questions regarding your checking and savings accounts, including the number of accounts and estimated balances.
7. Identify a contact person if you wish to have someone else represent your application.
8. Provide the details of your landlord or mortgage company, including the amount of rent or mortgage due and any payments that may be past due.
9. Complete the section for utility companies in your area, including past due amounts and contact information.
10. Attach copies of necessary documentation, including recent utility bills, rental agreements, and your most recent pay stubs for review.
11. Craft a personal statement outlining your situation and why you require assistance, which is a critical part of your application.
12. Review your application for completeness and accuracy. Once you are satisfied, save the document.
13. Print the completed application and all attached documents to send them by mail to the specified P.O. Box.

Start your application now and take the first step towards receiving assistance.