King of Kings Benevolence Application

King of Kings Benevolence Application

“Be joyful always; pray continually; give thanks in all circumstances, for this is God’s will for you in Christ Jesus.” 1 Thessalonians 5:16-18
King of Kings Church is accepting applications for financial assistance related to utilities (OPPD, MUD, etc.), rent, medical bills, or other pressing needs. We do not pay phone or cable bills. Hotels, transportation and other needs are evaluated on a case-by-case basis. Each request will be evaluated based on the need and availability of funds.

Fill out the Benevolence Application completely. Take a clear photo or scan in the following documents to be s
1. Current Photo ID
2. Copy of the bill you are requesting for payment
3. Proof of financial need — this document can be a monthly bank account statement, copy of bank card statement, etc.
We will get back to you with an answer within a few days of receiving your application.

If approved, mailed checks will be sent to pay debts directly, according to the standard mail delivery time (5-10 business days).
Today's Date*

MonthDayYear
Date
Name*

First NameLast Name
Address

Street Address

Street Address Line 2

CityState

Zip Code
Phone Number*
Email*
example@example.com
How did you hear about King of Kings?

I am a King of Kings MemberI am a King of Kings VolunteerOther

Employment Information

Please fill out employer or unemployed information. One is required.
Employer
How Long?
Employer Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Employer Phone Number
If unemployed, How Long?
Reason for unemployment?

Your Need
Total Amount of Need*
What has happened to create this need? (Loss of employment, sudden medical illness, etc.)*
Describe the need/bill that is unmet in the lines provided below:*

Payment Information

In order to fulfill the need described, a check should be made payable to:
Pay To:*
Ex. Business Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Account Number
Other Account Information to Reference:

Total Assets:
*List each individual unpaid bill (add additional rows if necessary)
Total Debts:
Please Attach the Following:
Copy of current driver’s license*

Browse Files

Cancelof
Copy of unpaid bill*

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Proof of financial need*

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This document can be a monthly bank account statement, copy of bank card statement, previous year's tax return, etc. Cancelof
Benevolence Payments will be granted only if King of Kings has available funds in the Good Samaritan Account and if a valid financial need exists.

We will get back to you with an answer within 5-10 business days of receiving your application by email or phone. Please DO NOT TO CALL King of Kings Church to see if funds are available.
Term & Conditions*

By submitting this I acknowledge that all information is correct and I lack the resources to meet the need as described in this application.
Should be Empty:

Your Need