o Completed Application – signed and dated. Please type or clearly print all entries on the application. If more space is needed attach a separate sheet(s).
o Statement of future sustainability plan (see above).
o Proof of Military Status
o Examples: DD Form 214, VA Medical Center ID Card, Military Retiree Identification, Veteran Identification Data, USDVA letter verifying service.
o Proof of residency, such as Driver License/State ID, or mail showing physical address.
o Most recent pay stub, showing payroll and deductions.
o Necessary documentation or statement(s) indicating emergency financial need.
o Examples: eviction or foreclosure notice, utility shut-off notice, rental agreement and terms, billing statements, repair estimates, cost estimates, bank statements, accounting records
o Taxpayer identification number or social security number, name, address, and phone number of the creditor(s) to whom payment will be made.
· Examples: landlord, mortgage company, doctor, repair company, utility company.
o If a medical or dental condition is involved, include a doctor’s written statement indicating emergency and quote on cost.
o An un-remarried spouse of a deceased veteran must also provide copies of the marriage certificate and the death certificate
o Provide three personal reference letters
o Provide contact information from you VA case worker and letter of reference (if applicable)