Follow the steps to complete your application successfully.

1. Click 'Get Form' button to access the application form and open it in your preferred online editor.
2. Begin filling out the application by indicating whether you or someone in your household has experienced negative impacts due to COVID-19 by selecting 'Yes' or 'No'.
3. Enter your name in the 'Name of Applicant' field and provide your email address in the designated area.
4. Record the date of application in the appropriate section.
5. Provide both your mailing and physical addresses as required in the respective fields.
6. Fill out your contact numbers, including home and cell phone, along with a message if desired.
7. List the names and enrollment numbers of all household tribal members in the designated boxes.
8. Indicate the number of additional household members present and list their names.
9. For requested services, fill in the associated costs related to housing, including information about rent, mortgage, utilities, and repairs. Be sure to attach supporting documentation showing recent account information or receipts.
10. Specify any household items requested, including food, sanitary supplies, and medical supplies, including vendor details.
11. Detail any medical care, emergency protective measures, remote communications equipment, and other unforeseen services, providing a description and associated costs for each.
12. Sign the attestation section certifying that you are not requesting duplicate assistance and agree to the conditions outlined.
13. Complete your application by saving changes, downloading, printing, or sharing the form as needed.

Start your application process today and ensure your household receives the support it needs.