TCF English

Please enter today's date:*

MonthDayYear

Applicant's Name*

First NameLast Name

Applicant's Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Applicant's Email*

example@example.com

Applicant's Phone Number*

Area CodePhone Number

United StatesPuerto RicoCanada

TMX/Employee ID *

Note: If you do not know your Employee ID Number, please log into UltiPro. You can also find your employee number in HotSchedules which is listed as HR ID.

Restaurant (Location name)*

Locations are listed in alphabetical order. Please scroll until you find your correct location.

Please indicate your GM/ Corp Department Head's Name*

Please indicate your combined family pre-disaster gross monthly income:

Amount is in US$

Basic Needs (Up to $1,000.00) Financial hardship grant to provide for basic needs such as shelter, food, utilities and/or childcare when a staff member is unable to work or meet these basic needs due to an unexpected emergency situation. Ongoing medical expenses will generally not be considered for grants.Loss of a Staff Member's Spouse (Up to $1,000.00) Expenses related to a death of a staff member’s spouse. Grants are intended for travel and funeral-related expenses.Loss of a Staff Member's Child (Up to $1,000.00) Expenses related to a death of a staff member’s child. Grants are intended for travel and funeral-related expenses.Loss of a Staff Member's Parent (Up to $1,000.00) Expenses related to a death of a staff member’s parent. Grants are intended for travel and funeral-related expenses.Housing Disaster (Up to $2,500.00) Urgent or extraordinary expenses as a result of a catastrophe, natural disaster or accident to a primary residence to include “Qualified Disasters”, as defined in sections 139(c)(1),(2) and (3) of the IRS CodeLoss of a Staff Member (Up to $1,000.00) In the case of a staff member’s own death, grants are issued directly to a service provider for funeral-related expenses.

Describe in detail the nature of the event and why it creates a financial hardship for you (details should include the date of the event)*

YesNoN/A- I am not applying for Death of an Immediate Family Member grant

*If application is for Death of an Immediate Family Member, please indicate the following: 1) Name and relationship of deceased (i.e., Jane Doe, Mother). 2) Name, address, and phone number of the funeral home/mortuary that will be providing the services for your loved one.

*If application is for Death of a Staff Member, please provide the name, address, and phone number of the funeral home/mortuary that will be providing the services.

(Note: If a grant is approved the funds will be sent directly to the funeral home or mortuary.)

YesNo

If you answered Yes to having previously received a HELP Fund Grant, please indicate when you received it.

Please attach the appropriate documentation.

If your attachment is too large or you have more than 5 documents to attach, please submit additional documentation via email helpfund@thecheesecakefactory.com or via fax at 571-248-3001.

Acceptable File Formats: pdf, doc, docx, xls, xlsx, csv, txt, rtf, jpg, jpeg, png, gif

If applying for a Basic Needs grant, the committee would need copies of utility bills and/or lease agreement/mortgage bill and anything documenting the unexpected emergency.

If applying for Loss of an Immediate Family Member (spouse, child, or parent) grant, the committee would need at least one of the following: death certificate, funeral home invoice/estimate, or obituary/funeral program.

If applying for a Housing Disaster, the committee would need some proof of the disaster which can include a photo, a newspaper article, and/or a fire report from the fire department, etc. Additionally, our records must match the address.

Note: Applications that do not have documentation are not able to be processed until documentation is received. Please speak to your GM if you have any questions.

Please attach the appropriate documentation. *

Note: Applications that do not have the correct documentation are not able to be processed until the correct documentation is received. Please speak to your GM if you have any questions.

I have spoken to my general manager/department head regarding this application.I AM the general manager/department head that is submitting the application on behalf of myself or a staff member.I have NOT spoken to my GM/department head. I understand that the HELP Fund administrator will be contacting my GM/department head regarding this application.

APPLICANT DECLARATION: By signing below, under penalty of perjury, I declare, to the best of my knowledge and belief, the above stated information is true and correct. I agree that sources may be contacted to verify information contained in this application and that The Cheesecake Factory may use content from my application for future marketing purposes. I understand that if the event I am applying for or receiving a grant for misrepresents my circumstances, the Company reserves the right to exercise disciplinary action, up to and including discharge. Additionally, I authorize United Charitable and The Cheesecake Factory to disclose any confidential and/or financial information to the HELP Fund Committee as it pertains to the above event. *

Applicant Name*

First NameLast Name

Applicant Signature*

The HELP Fund Application