2022 COVID-19 Direct Financial Assistance Program

2022 COVID-19 Direct Financial Assistance Program

American Rescue Plan Act (ARPA)
Did you apply for COVID-19 Direct Financial Assistance in 2021? *

Yes No

You do not need to apply. We have your information on file from your previous application. Please be patient. POZ Direct Financial Assistance payments will be processed within 4-6 weeks.

If you have further questions, FAQ's can be found at www.ashiwi.org

Purpose of Program:

The American Rescue Plan Act (ARPA) COVID-19 Direct Financial Assistance Program is available to all Zuni enrolled tribal members over the age of 18 years. The purpose of the program is to provide direct financial payments to support tribal members that have been negatively impacted and affected by COVID-19. The direct financial assistance payments are designed to provide non-taxable economic relief to Zuni Tribal enrolled members with additional resources to maintain adequate housing, transportation, food, water, medication, medical care, utilities, and basic life necessities to help alleviate the financial hardships endured from loss of income and/or increased costs due to the COVID-19 pandemic recovery efforts. Funding for the program is supported by the American Rescue Plan Act (ARPA) received by the Zuni Tribe. This direct financial assistance program is designed to comply with the ARPA requirements and guidance issued by the US Department of Treasury.
Please submit ONLY ONE application per person
*

New Applicant
New applicants must upload their Tribal Enrollment Verification & a photo ID or driver's license

Cancel of
Name *

First Name Last Name
Middle Name Suffix
Date of Birth *

Month Day Year
Date
Age *
Social Security Number *
example: 123456789 (no space or dash. Numbers only)
Zuni Tribal Census Number *
example: 123456 (no space or dash. Numbers only)
Current Telephone Number *
Current Mailing Address (Please include City & Zip Code) *
Current Physical Address (Please include City & Zip Code *
Email Address
example@example.com
Please check from list of situations below that apply to you as an impact related to the COVID - -19 public health emergency: *

Loss of Employment/Temporary Layoff or Furlough. Reduction in hours/pay. Unable to work or experiencing financial hardship due to no child care/school. Had to close business/loss of self-employment revenue. Teleworking and related job changes. Children being schooled at home/distance learning. Underlying medical condition requiring staying home to prevent exposure. Over the age of 50 and enduring increased costs related to the COVID-19 pandemic. Difficulty accessing healthy foods. Difficulty paying rent/mortgage. Did not receive federal stimulus funding. Contracted COVID-19. Disabled and enduring increased costs related to the COVID-19 pandemic. Experienced increased essential costs due to COVID-19 (i.e. paid a higher price for essential items) Other financial hardship:
Please explain
Certification
By signing below, I Print Name* certify that the above information is true and correct to the extent of my knowledge. I understand that submitting false information may be considered a crime and is punishable under Tribal and Federal Law. I further agree that the funds distributed by the tribe shall be used for General Welfare and only to purchase essential goods and services to relieve the impacts of COVID-19.
Signature of Applicant *

Clear
Date *

Month Day Year
Date
Should be Empty:

2022 COVID-19 Direct Financial Assistance Program

You do not need to apply. We have your information on file from your previous application. Please be patient. POZ Direct Financial Assistance payments will be processed within 4-6 weeks.

Please submit ONLY ONE application per person

Certification