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  • Lummi Nation Unmet Needs Distribution Intake Form

Get Lummi Nation Unmet Needs Distribution Intake Form

LUMMI NATION UNMET NEEDS DISTRIBUTION INTAKE FORM This form will be used for Lummi Nation internal use only. The information contained on this form is not for distribution to any outside agency or entity. APPLICANT INFORMATION First Name MI Last Name NAME OF LEGAL GUARDIAN/PARENT if minor Mailing Address City State Zip Lummi Enrollment Social Security -- Date of Birth// Phone Number Emergency Contact Name Emergency Contact - CERTIFICATIONS I am or the minor child is a member of Lummi Nation and I or the minor child meets the criteria for basic unmet needs per LIBC Resolution 2016-180. I will use this assistance to meet those unmet needs. I affirm that I am the legal guardian of the minor child and have attached the relevant documentation regarding custody if applicable. By my signature below and acceptance of this ONE-TIME payment I affirm and declaration that all of the above statements are true and accurate. Signature Date All original forms must be turned into the LIBC Treasurers Of....

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How to fill out the Lummi Nation Unmet Needs Distribution Intake Form online

Completing the Lummi Nation Unmet Needs Distribution Intake Form is essential for accessing necessary support. This guide provides clear, step-by-step instructions on how to properly fill out the form online, ensuring that users can effectively communicate their needs.

Follow the steps to successfully complete the intake form.

  1. Click the ‘Get Form’ button to retrieve the form and open it in your preferred editor.
  2. Begin by filling out the 'Applicant Information' section. Provide your first name, middle initial, and last name. If you are completing this form for a minor, include their legal guardian or parent's name in the designated area.
  3. Next, enter your mailing address, including city, state, and zip code. This will help ensure that any correspondence or support sent will reach you.
  4. Input your Lummi Enrollment number and Social Security number. Be sure to enter the correct date of birth in the specified format.
  5. Provide your phone number and email address. This information will be used for any follow-up or questions regarding your application.
  6. Fill out the emergency contact section with the name and phone number of someone who can be reached in case of an emergency.
  7. In the 'Certifications' section, confirm that you or the minor child is a member of the Lummi Nation and check the criteria for basic unmet needs eligibility. Ensure all boxes are checked to affirm this.
  8. If applicable, attach any necessary documentation regarding guardianship of a minor child. This ensures that all legal requirements are met.
  9. Finally, provide your signature and the date. This will affirm that the information provided is accurate and truthful.
  10. Once you have completed the form, save your changes, download a copy for your records, and prepare to submit it either in person or via email to the Treasurers Office.

Start filling out your Lummi Nation Unmet Needs Distribution Intake Form online today to access the support you need.

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We are the Lhaq'temish, The Lummi People. We are the original inhabitants of Washington's northernmost coast and southern British Columbia. For thousands of years, we worked, struggled and celebrated life on the shores and waters of Puget Sound. We are fishers, hunters, gatherers, and harvesters of nature's abundance.

Living on Lummi Island offers a change of pace, a closer connection to the natural world, and greater involvement in a small community.

The black-edged oval seal of the Lummi people, centered on the flag, depicts an eagle in traditional Salish style in black, white, yellow, and red (seal provided by Squoi Quoi, Lummi newspaper).

Lummi (Xwlemi Chosen, IPA: [xʷləmi tʃɔsən]) is a dialect of the North Straits Salish language traditionally spoken by the Lummi people of northwest Washington, in the United States. Although traditionally referred to as a language, it is mutually intelligible with the other dialects of North Straits.

They established villages near the sea and in the forests, and moved ing to the seasons. They lived in multi-family cedar-plank longhouses. The freshwater streams and estuaries of Lummi territory are home to crabs, shrimp, marine fish, salmon, and birds.

Hy'shqe is the Lummi word for "thank you."

Once the customer has completed and submitted an application or review, they can then call our Contact Center at 1-877-501-2233 between 8am and 2pm (on business days) and request a callback appointment.

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